-NRLF 


135    D5M 


GIFT  OF 

WILLIAM  DILLER  MATTHEW 


EARTH 

SCIENCES 

LIBRARY 


WILLIAM   DILLER   MATTHEW 


THE 

SCIENCE-  HISTORY 
OF    THE    UNIVERSE 


FRANCIS  ROLT- WHEELER 

MANAGING  EDITOR 


IN  TEN  VOLUMES 


THE  CURRENT  LITERATURE  PUBLISHING  COMPANY 

NEW  YORK 

1909 


INTRODUCTIONS 

PROFESSOR  E.  E.  BARNARD,  A.M.,  Sc.D^ 
Yerkes  Astronomical  Observatory. 

PROFESSOR  CHARLES  BASKERVILLE,  Ph.D.,  F.C.S. 
Professor  of  Chemistry,  College  of  the  City  of  New  York. 

DIRECTOR  WILLIAM  T.  HORNADAY,  Sc.D., 
President  of  New  York  Zoological  Society. 

PROFESSOR  FRSDERT'QK.  STARR,  S.B.,  S.M.,  Ph.D., 
Professor  of  Anthropology,  Chicago  University. 


PROFESSOR  CASSIUS  J.  KEYSER,  B.S.,  A.M.,  Ph.D., 
Adrain  Professor  of  Mathematics,   Columbia  University 


EDWARD  J.  WHEELER,  A.M.,  Litt.D., 
Editor  of  'Current  Literature.' 


PROFESSOR  HUGO  MUNSTERBERG,  A.B.,  M.D.,  Ph.D.,  LL.D., 
Professor  of  Psychology,  Harvard  University. 


EDITORIAL    BOARD 

VOL.  I — WALDEMAR  KAEMPFFERT, 
'Scientific  American.' 

VOL.  II — HAROLD  E.  SLADE,  C.E. 
VOL.  Ill — GEORGE  MATTHEW,  A.M., 

VOL.  Ill — PROFESSOR  WILLIAM  J.  MOORE,  M.E., 

Assistant  Professor  of  Mechanical  Engineering,  Brooklyn 

Polytechnic  Institute. 

VOL.  IV — WILLIAM  ALLEN  HAMOR, 

Research  Chemist,  Chemistry  Department,  College  of  the 
City  of  New  York. 

VOL.  V — CAROLINE  E.  STACKPOLE,  A.M., 
Tutor  in  Biology,  Teachers'  College,  Columbia  University. 

VOL.  VI— WM.  D.  MATTHEW,  A.B.,  Ph.B,  A.M.,  Ph.D., 

Assistant    Curator,    Vertebrate    Paleontology,    American 

Museum  of  Natural  History. 

VOL.  VI — MARION  E.  LATHAM,  A.M., 
Tutor  in  Botany,  Barnard  College,  Columbia  University. 

VOL.  VII— FRANCIS  ROLT-WHEELER,  S.T.D. 
VOL.  VII— THEODORE  H.  ALLEN,  A.M.,  M.D. 

VOL.  VIII— L.  LELAND  LOCKE,  A.B.,  A.M., 
Brooklyn  Training  School  for  Teachers. 

VOL.  VIII— FRANZ  BELLINGER,  A.M.,  Ph.D. 

VOL.  IX— S.  J.  WOOLF. 
VOL.  IX— FRANCIS  ROLT-WHEELER,  S.T.D. 

VOL.  X — PROFESSOR  CHARLES  GRAY  SHAW,  Ph.D., 
Professor  of  Ethics  and  Philosophy,  New  York  University. 

LEONARD  ABBOTT, 
Associate  Editor  'Current  Literature/ 


THE 

SCIENCE-  HISTORY 
OF    THE     UNIVERSE 


VOLUME  VII 


ANTHROPOLOGY 

By  FRANCIS  ROLT- WHEELER 


MEDICINE 

By  DR.  THEODORE  H.   ALLEN 


INTRODUCTION 

By  PROFESSOR  FREDERICK  STARR 

UNIVERSITY  OP  CHICAGO 


Copyright,  1909,  by 
CURRENT   LITERATURE  PUBLISHING  COMPANY 


CONTENTS 

PART  I— ANTHROPOLOGY 

CHAPTER  PAGE 

INTRODUCTION  BY  PROFESSOR  STARR ix 

I    MAN'S  PLACE  IN  NATURE i 

II  ANTHROPOMETRY 20 

III  THE  UNITY  AND  VARIETY  OF  MAN 32 

IV  THE  RACIAL  DIVISIONS  OF  MAN 49 

V    PREHISTORIC  ARCHEOLOGY 64 

VI  THE  DEVELOPMENT  OF  CULTURE. 87 

PART  II— MEDICINE 

I     THE  ANCIENTS 101 

II    THE  GREEKS 121 

III  THE  ROMANS  139 

IV  BYZANTINE  AND  ARABIAN  SCHOOLS 151 

V    THE  CLOSE  OF  MEDIEVALISM 168 

VI    THE  CENTURY  OF  SCHOOLS 185 

VII  THE  PERIOD  OF  SYSTEM ATIZATION 211 

VIII     THE  CONTRIBUTIONS  OF  THE  PRACTITIONER 226 

IX    NINETEENTH-CENTURY  THEORIES  241 

X    MODERN  TREATMENT  OF  DISEASE 251 

XI     MODERN  PHYSIOLOGY  .         262 


INTRODUCTION 

No  OTHER  science  deals  with  a  field  so  ill  defined  as  An- 
thropology, no  other  studies  so  varied  and  differing  ma- 
terial. The  scope  and  the  content  of  the  science  are  alike 
matters  of  dispute.  By  derivation  the  word  of  course 
means  a  discourse  or  treatise  regarding  man.  It  has  been 
defined  as  that  branch  of  science  which  studies  man  in  the 
same  way  as  geology  investigates  the  earth  or  as  botany 
investigates  plant  life.  The  motto  of  the  Department  of 
Anthropology  in  the  World's  Columbian  Exposition  was 
"Man  and  his  works."  It  is  evident  that  any  science 
which  studies  man  and  his  works  has  a  limitless  field. 
Anthropology  depends  upon  the  whole  range  of  other 
sciences.  It  has  a  dozen  connections  with  Astronomy;  it 
is  closely  related  with  Geology;  it  assumes  an  enormous 
knowledge  of  Biology;  to  a  great  degree  it  includes  An- 
atomy, Physiology,  Psychology;  it  uses  the  methods  of 
Mathematics ;  it  is  intertwined  with  History ;  Linguistics 
and  Philology  yield  a  notable  contribution  to  its  store.  Is 
it  possible  to  mark  out  a  definite  field  for  its  investigation 
and  to  group  and  classify  its  materials?  More  and  more 
its  students  feel  that  it  has  its  definite  field,  its  legitimate 
subdivisions  and  its  special  methods  of  investigation. 
Roughly  we  may  divide  the  materials  of  Anthropology 
under  the  four  subdivisions  of  Somatology,  Ethnology, 
Ethnography  and  Culture  History.  Under  the  latter  we 
must  rank  Prehistoric  Archeology,  perhaps  the  most 
popular  subdivision  of  the  field. 

Somatology,  or  Physical  Anthropology,  deals  with  man 


x  INTRODUCTION 

as  a  living  being.  In  reality  it  treats  of  two  quite  different 
matters:  First,  it  investigates  man's  place  in  nature;  it 
locates  him  in  his  proper  place  in  the  scale  of  animal  life ; 
it  considers  the  question  of  his  origin;  it  discusses  his 
relation  to  the  anthropoids  and  other  simian  forms;  it 
aims  to  trace  his  family-tree  back  to  a  primal  trunk.  Sec- 
ond, it  considers  man  in  himself  as  an  organism.  It  neces- 
sarily includes  the  fundamental  facts  of  anatomy,  physi- 
ology and  psychology.  It  lays  the  foundation  for  Eth- 
nology. Ethnology  is  the  philosophical  study  of  human 
races.  If  we  recognise — and  the  distinction  is  a  good  one 
• — the  difference  between  'logy'  and  'graphy'  sciences,  we 
shall  clearly  understand  its  scope.  From  the  materials 
supplied  by  Somatology  it  aims  to  define  the  types  of  man. 
Such  types  are  based  primarily  upon  physical  characters. 
Color,  character  of  hair,  head-form,  stature,  the  form  and 
character  of  facial  features,  variations  in  proportion — these 
and  other  characters  are  studied  and  combinations  of  them 
found  existing  among  groups  of  human  beings  are  built 
up  into  race  types.  Having  defined  the  different  types  of 
man  now  existing,  the  ethnologist  deals  with  such  ques- 
tions as  the  cause  and  extent  of  variation  and  the  history 
of  these  types  through  the  past.  He  is  interested  in  the 
great  problems  of  migration,  acclimation,  miscegenation 
and  the  like.  Ethnography,  as  its  name  indicates,  is  a 
descriptive  science.  It  bears  the  same  relation  to  Eth- 
nology that  Geography  bears  to  Geology.  It  is  the  least 
philosophical,  the  least  important,  but  the  most  popularly 
interesting  of  the  sub-fields  of  Anthropology.  A  general 
ethnography  would  be  a  complete  description  of  the  life 
and  habits,  thoughts  and  condition  of  each  and  every 
population  on  the  globe.  The  special  ethnography  of  any 
people  is  the  detailed  description  of  its  entire  life.  Cul- 
ture History  deals  with  the  same  materials  as  Ethnogra- 
phy, but  in  a  different  manner.  From  the  data  furnished 
by  the  ethnographer,  dissociated  from  the  peoples,  it  aims 
to  trace  the  progress  of  culture  from  the  rudest  savagery 


INTRODUCTION  xi 

to  the  highest  civilization;  it  aims  to  follow  the  evolution 
of  ideas ;  it  studies  the  beginnings  and  development  of 
institutions;  it  is  the  highest  product  of  anthropological 
study. 

Such  is  the  field  of  Anthropology,  such  are  its  most  gen- 
erally recognised  divisions.  The  tendency  of  students  is 
to  devote  themselves  to  one  or  another  of  these  four  great 
subdivisions.  Thus  practical  workers  are  likely  to  be 
Somatologists,  Ethnologists,  Ethnographers,  students  of 
Culture  History,  Archeologists.  While  this  is  true,  the 
propriety  of  a  general  term  which  shall  include  them  all  is 
more  and  more  emphatically  recognised. 

The  fact  that  man  is  himself  the  subject  of  study  has 
made  the  progress  of  the  science  exceptionally  difficult. 
Prejudice  has  entered  into  the  discussion  of  the  great 
problems  of  the  science  as  it  has  not  done  in  such  subjects 
as  Astronomy  and  Mathematics,  Geology  and  Zoology. 
This  is  well  shown  in  the  great  question  of  the  unity  of 
mankind.  The  battle  between  the  monogenist  and  the 
polygenist  has  been  a  bitter  one;  views  have  fluctuated; 
religious  and  political  ideas  and  theories  have  tinged  dis- 
cussion. Monogenism  was  good  religion  in  the  early  part 
of  the  nineteenth  century.  With  the  promulgation  of  Dar- 
winism many  theologians  were  thrown  into  the  camp  of 
the  polygenists  as  their  only  escape  from  the  hated  revolu- 
tionary evolutionary  doctrine.  A  whole  school  of  Ameri- 
can polygenists  came  into  existence  at  the  time  of  heated 
discussion  regarding  slavery.  To-day  the  long-mooted 
question  has  little  significance.  Since  evolution  has 
been  established  and  is  assumed  as  a  working  hypothe- 
sis in  every  science,  the  question  whether  man  is  one  or 
several  species  is  simply  the  question  as  to  how  far  back 
we  will  draw  the  line  across  the  divergent  branches  of  the 
human  kind. 

The  question  of  man's  antiquity  has  been  the  cause  of 
many  a  battle.  A  quarter  of  a  century  of  heated  discus- 
sion was  necessary  before  the  claim  of  Boucher  de  Perthes 


xii  INTRODUCTION 

that  man  existed  before  present  geological  conditions  was 
accepted.  In  1859  man's  antiquity  was  admitted  as  far 
back  as  the  glacial  period.  When  De  Mortillet  wrote  his 
masterly  manual  of  Prehistoric  Archeology  claims  of 
greater  antiquity  were  before  the  public.  In  one  and  an- 
other locality  objects  had  been  found  which  were  believed 
to  demonstrate  man's  existence  in  the  Tertiary.  De  Mor- 
tillet examined  the  whole  material.  Rejecting  far  the 
greater  part,  he  believed  that  enough  remained  to  warrant 
the  assumption  that  an  intelligent  being,  a  tool-user,  ex- 
isted in  that  geological  division  of  time.  When  he  pre- 
sented his  views,  few  were  ready  to  accept  them.  To-day 
the  whole  matter  has  been  revived  and  one  of  the  most 
bitter  discussions  of  the  moment  is  being  waged  over  the 
so-called  "Eoliths."  The  crude  tools  for  which  Boucher 
de  Perthes  contended  are  finely  finished  works  of  art  com- 
pared with  the  rude  flakes  over  which  the  present  argu- 
ment is  being  conducted.  The  paleolithic  relics  are  inten- 
tionally shaped;  the  eolith  is  simply  a  natural  flake  or 
splinter  which  shows  evidence  of  use.  The  representative 
of  the  eolith  argument  to-day  is  Professor  Rutot,  of  Bel- 
gium. His  claim  is  distinctly  that  an  eolith  is  a  flake  or 
splinter  of  flint,  produced  by  natural  causes,  which  has 
been  used  by  an  intelligent  being  for  pounding,  scraping, 
rasping,  cutting  or  sawing.  Such  objects  have  now  been 
found  by  thousands  in  France  and  Belgium,  Germany  and 
England.  In  age  they  range  from  the  early  Quaternary 
(or  Glacial  Period)  back  to  the  middle  Tertiary.  Against 
a  storm  of  opposition  and  argument  Rutot  presents  a  mas- 
terly argument  in  favor  of  their  authenticity.  Whether 
these  eoliths  are  to  be  attributed  to  man  or  to  some  other 
intelligent  being  awaits  the  fortunate  find  of  remains  as 
yet  undiscovered. 

It  is  a  common  assumption  that  primitive  man  was'  un- 
sophisticated, a  being  endowed  with  possibilities,  a  creature 
of  undeveloped  talents.  This  assumption  has  been  almost 
universal  in  all  studies  of  culture  history.  A  little  thought 


INTRODUCTION  xiii 

clearly  demonstrates  that  such  a  being  never  can  have 
existed.  Assuming  man's  animal  ancestry,  we  are  driven 
to  believe  that  many  things  which  are  ordinarily  consid- 
ered as  being  human  must  have  arisen  in  a  prehuman, 
brute  condition.  It  is  certain  that  the  ancestor  of  man 
must  have  been  a  social  species.  Is  it  not  quite  as  certain 
that  before  he  had  developed  into  anything  which  could 
be  considered  human  certain  fundamental  facts  of  social 
life  must  have  existed?  The  simplest  ideas  of  rights  and 
duties,  of  personal  property,  of  friendship  and  hostility, 
of  the  use  of  nature-supplied  implements,  of  communica- 
tion, perhaps  of  animism — raw  stuff  of  religion — may  well 
have  been  developed  by  the  brute,  non-human  ancestor. 
In  other  words,  the  being  whom  we  call  primitive  man 
had  already  a  respectable  capital.  This  point  of  view  ren- 
ders all  serious  study  of  animal  psychology  particularly 
interesting  to  the  anthropologist.  Such  books  as  Groos' 
'Play  of  Animals*  and  Tlay  of  Men'  are  most  suggestive. 
There  is  as  yet  practically  nothing  that  can  be  called  a 
study  of  the  psychology  of  anthropoid  apes.  Such  a  study 
would  be  of  interest  and  significance.  Not  that  it  is  as- 
sumed that  any  one  of  the  existing  anthropoids  is  ances- 
tral to  humanity.  They  are  our  cousins,  not  our  progeni- 
tors. A  correct  picture  of  their  mental  operations  would 
not  be  that  of  our  precursor,  but  they  and  we  have  in- 
herited from  the  same  ancestry. 

Ethnographers  to-day  divide  into  hostile  camps  upon 
the  question  of  the  significance  of  similarities  in  culture 
in  widely  separated  areas.  When  one  finds  a  striking  de- 
tail or  feature  of  custom  or  belief  in  populations  widely 
separated,  the  immediate  and  natural  assumption  has  al- 
ways been  that  this  similarity  indicated  relationship  or 
contact  in  the  past.  The  assumption  is  a  dangerous  one 
and  has  been  so  frequently  and  rashly  made  as  to  bring 
contempt  upon  the  method.  It  is  so  easy  in  finding  a  few 
simple  customs  among  the  American  Indians  which  re- 
semble the  practices  of  the  old  Jews  to  assume  that  the 


xiv  INTRODUCTION 

Indians  are  the  "Ten  Lost  Tribes  of  Israel" !  A  revolt 
upon  the  part  of  thoughtful  students  against  such  loose 
and  careless  comparison  and  assumption  was  natural. 
There  is  no  question  that  this  revolt  has  been  carried  to  a 
ridiculous  extreme.  It  finds  its  fullest  development  in 
Daniel  G.  Brinton,  through  years  the  leader  in  American 
Ethnology.  For  Dr.  Brinton  and  the  great  school  of  Eth- 
nologists of  which  he  was  a  spokesman,  simialrities  in 
culture  do  not  necessarily  show  relationship,  or  contact,  or 
evidence  of  migration,  but  simply  demonstrate  the  psychi- 
cal unity  of  mankind.  His  thesis  was  that  everywhere 
the  human  mind  subjected  to  similar  conditions  would 
strike  out  similar  results.  The  same  thought,  the  same 
belief,  the  same  practice,  the  same  art  and  industry  might 
originate  independently  in  two  or  many  different  sections 
of  the  globe.  The  argument  is  interesting  and  valuable, 
but  may  become  misleading.  Every  one  admits  the  psychic 
uniformity  of  man.  But,  for  most  students,  close  and 
peculiar  similarities  of  the  details  in  stories,  in  games,  in 
religious  practices,  in  complicated  mechanical  devices  sug- 
gest actual  contact  in  the  past.  No  such  contact  should 
be  carelessly  assumed,  every  case  should  be  rigidly  investi- 
gated ;  but  the  true  ethnographer  must  weigh  with  care  all 
such  likenesses. 

Major  Powell  divided  the  field  of  Culture  History  into 
five  divisions.  These  he  called  Esthetology,  Technology, 
Sociology,  Philology  and  Sophiology.  Art,  Industry,  So- 
ciety, Language  and  Belief  are  the  five  expressions  of  the 
human  mind.  Each  is  ample  to  fully  occupy  many  students 
for  an  indefinite  period  in  the  future.  Each  will  yield  its 
harvest.  Into  each  the  student  must  carry  the  methods  of 
rigid  scientific  study.  When  one  realizes  the  enormous 
scope  of  any  one  of  these  and  then  appreciates  its  proper 
place  as  a  small  section  in  Culture  History,  itself  but  one 
of  the  four  great  subdivisions  of  Anthropology,  he  begins 
to  realize  the  magnitude  of  the  scope  and  content  of  this 
important  study.  FREDERICK  STARR. 


ANTHROPOLOGY 

CHAPTER  i 

MAN^S    PLACE    IN    N ATI  RE 

DESPITE  what  philosophers  may  say,  Man  to  himself  will 
always  be  the  center  of  the  universe.  It  may  be  possible 
that  beings  superior  to  Man  even  now  do  exist,  tho  unrec- 
ognised by  human  sense,  in  the  same  manner  that  Man 
cannot  be  understood  by  the  minute  corpuscles  in  his  blood. 
But  such  a  thought  is  so  strange  to  the  common  viewpoint 
that  it  seems  almost  fantastic,  and  Man's  Place  in  Nature, 
he  firmly  believes,  is  at  the  top,  while  the  only  idea  which 
has  reconciled  him  to  his  manifest  ancestry  in  the  lower 
orders  of  life  is  that  the  scale  of  evolution  points  to  him  as 
the  highest  form  yet  attained. 

Wherefore  Anthropology,  including  as  it  does  the  entire 
past  of  Man,  can  scarcely  be  regarded  as  a  single  science, 
and  the  anthropologist  is  conscious  of  a  certain  vagueness 
as  to  the  scope  of  his  labors.  Since  Man  in  a  sense  sums 
up  all  that  has  gone  before,  all  is  included  in  him,  and  since 
his  present  position  cannot  rightly  be  understood  without 
reference  to  that  which  has  gone  before,  it  becomes  evident 
that  a  large  group  of  arts  and  sciences  which  appear  mutu- 
ally diverse  find  an  interdependence  in  him.  The  old  say- 
ing, "I  am  a  Man,  and  therefore  nothing  human  is  foreign 
to  me,"  fairly  expresses  the  ground  upon  which  the  an- 
thropological sciences  claim  attention. 

The  links  of  Anthropology  to  the  other  sciences  are 


2  ANTHROPOLOGY 

numerous  and  close.  Thus  there  is  what  in  France  is 
called  pure  anthropology  or  anthropology  proper,  but 
which  is  better  called  physical  anthropology — the  science 
of  the  physical  characters  of  man,  including  anthropometry 
and  craniology,  and  mainly  based  upon  anatomy  and  physi- 
ology. There  is  comparative  anthropology,  which  deals 
with  the  zoological  position  of  mankind.  There  is  prehis- 
toric r  archeology,  which  covers  a  wide  range  of  inquiry  into 
man's,  early  works,  and  has  to  seek  the  aid  of  the  geologist 
and  the  ^metallurgist.  There  is  psychology,  whi  \  compre- 
hends the  whole  operations  of  his  mental  faculties.  There 
is  linguistics,  which  traces  the  history  of  human  language. 
There  is  folk-lore,  which  investigates  man's  traditions, 
customs  and  beliefs.  There  are  ethnography,  which  de- 
scribes the  races  of  mankind,  and  ethnology,  which  differ- 
entiates between  them,  both  closely  connected  with  geo- 
graphical science.  There  is  sociology,  which  applies  the 
learning  accumulated  in  all  the  other  branches  of  anthro- 
pology to  man's  relation  to  his  fellows  and  requires  the 
cooperation  of  the  statistician  and  the  economist;  and 
each  and  every  one  of  these  is  an  immense  subject,  while 
nothing  has  been  said  of  the  manner  in  which  all  human 
sestheticism  traces  its  spring  to  prehistoric  times. 

Also  there  is  another  side  to  the  question.  Great  as  is 
the  diversity  of  the  anthropological  sciences,  their  unity  is 
still  more  remarkable.  The  student  of  man  must  study  the 
whole  man.  No  true  knowledge  of  any  human  group,  any 
more  than  of  a  human  individual,  is  obtained  by  observa- 
tion of  physical  characters  alone.  Modes  of  thought,  lan- 
guage, arts  and  history  must  also  be  investigated.  This 
simultaneous  investigation  involves  in  each  case  the  same 
logical  methods  and  processes.  It  will  in  general  be  at- 
tended with  the  same  results.  If  it  be  true  that  the  order 
of  the  universe  is  expressed  in  continuity  and  not  in  cata- 
clysm, the  same  slow  but  sure  progress  must  be  evident 
in  each  branch  of  the  inquiry.  Thus  nothing  is  lost,  no 
race  is  absolutely  destroyed,  everything  that  has  been  still 


MAN'S    PLACE    IN    NATURE  3 

exists  in  a  modified  form  and  contributes  some  of  its  ele- 
ments to  that  which  is. 

There  is  yet  a  deeper  sense  of  study  which  traces  back 
the  very  roots  of  thought,  for  it  would  be  as  idle  to  study 
the  human  body  alone  without  reference  to  that  of  any 
other  creature  and  attempt  in  that  way  to  decipher  its 
genesis,  development  and  meaning  as  to  attempt  to  com- 
prehend a  single  human  mind  without  including  in  the  ex- 
amination not  only  other  human  minds  in  all  stages  of 
evolution,  but  equally  all  other  minds  to  which  that  of 
Man  is  related. 

The  debt  is  never  to  be  forgotten  that  is  owed  to  all 
minds  other  than  human,  "belonging,"  as  Sir  Daniel  Wil- 
son once  said  before  the  American  Association  for  the 
Advancement  of  Science,  "belonging  to  our  kinsfolk,  the 
animals,  minds  which  stand  to-day  like  mileposts  along  the 
almost  infinite  length  of  the  path  which  our  mind  has  fol- 
lowed in  its  upward  march  across  the  immensities  and  eter- 
nities from  its  remote  infancy  to  the  present  hour;  minds 
which  in  a  thousand  faculties  represent  to  us  everywhere, 
in  infinite  sameness  and  variety,  replicas  of  our  own  or  of 
parts  of  our  own,  showing  us,  as  the  poet  says,  tokens  of 
ourselves  which  we  'negligently  dropped  as  we  passed  that 
way  huge  times  ago/  " 

"As  man's  bodily  life  rests  upon  and  grows  from  that  of 
countless  prehuman  ancestors,"  says  Dr.  R.  M.  Bucks,  "as 
man  includes  in  his  structure  the  heart  of  the  reptile,  the 
gills  of  the  fish,  as  well  as  the  forms  in  outline  of  innumer- 
able still  lower  races,  so  is  his  so-called  human  mind  rooted 
in  the  senses  and  instincts  of  all  his  ancestral  species ;  and 
not  only  so,  but  these  senses  and  instincts  still  live  in  him, 
making  up,  indeed,  far  the  larger  part  of  this  current  every- 
day life;  while  his  higher  psychical  life  is  merely  the  out- 
growth and  flower  of  them. 

"As  truly  as  the  plant  is  an  embodiment  of  inorganic 
matter  vivified  b'y  the  transmuted  forces  which  in  the  non- 
vital  world  about  us  we  call  light  and  heat,  so  truly  is 


4  ANTHROPOLOGY 

man's  mind  the  outcome  of — the  expansion  and  culmina- 
tion of — the  imperfect  sensation  of  the  worm,  the  rudi- 
mentary sight,  hearing  and  taste  of  the  fish  and  reptile; 
and  the  simple  consciousness  which,  springing  from  these, 
passed  to  us  after  almost  infinite  ages  of  slow  evolution 
and  amelioration  through  tens  of  thousands  of  generations 
of  placental  mammals,  our  immediate  progenitors." 

In  the  growth  of  mind,  whether  that  of  the  race  or  of  an 
individual,  two  distinct  processes  are  observed:  First,  the 
very  gradual  evolution  to,  or  toward,  perfection  of  facul- 
ties that  have  already  come  into  existence;  and,  secondly, 
the  springing  into  existence  of  faculties  which  had  previ- 
ously no  existence.  For  it  is  clear  that  no  faculty  came 
into  mature  and  perfect  life  at  once.  Hearing  and  sight 
developed  by  slow  degrees  from  the  sense  of  touch,  and  in 
the  region  of  the  intellect  conceptual  life  was  born  from 
ages  of  receptual  and  that  from  millenniums  of  perceptual. 

Now  let  mind  be  supposed  growing  for  countless  years 
in  the  way  set  forth.  It  begins  as  mere  excitability ;  to  that 
after  a  long  time  is  added  what  may  be  called  discrimina- 
tion, or  choice  and  rejection  of,  for  instance,  different 
kinds  of  food.  After  another  long  interval  of  almost  in- 
finitely slow  advance  sensation  appears,  and  with  it  the 
capacity  of  pleasure  and  of  pain ;  then,  later  still,  memory ; 
by  and  by  recognition  of  offspring ;  and  successively  there- 
after arise  reason,  recognition  of  individuals  and  communi- 
cation of  ideas.  Concurrently  with  these  intellectual 
faculties  certain  moral  functions,  such  as  fear,  surprise, 
jealousy,  anger,  affection,  play,  sympathy,  emulation,  pride, 
resentment,  grief,  hate,  revenge,  shame,  remorse  and  a 
sense  of  the  ludicrous,  have  also  arisen  in  the  nascent 
mind.  This  is  the  mental  plane  of  the  higher  animals^ 
which  is  equally  that  of  the  human  being  at  about  two 
years  of  age.  Then  occurs  in  the  child  the  mental  expan- 
sion which  separates  man  from  the  higher  mammals — for 
something  like  a  year  the  child  mind  steadily  grows  from 
the  status  of  the  latter  to  the  status  of  the  human  mind. 


MAN'S    PLACE    IN    NATURE  5 

At  the  average  age  of  three  years  in  the  individual  self- 
consciousness  is  born,  and  the  infant,  from  the  point  of 
view  of  psychology,  has  become  a  human  being. 

For  human  being  he  is  and  as  such  is  distinctly  different 
from  a  mere  animal.  Elie  Metchnikoff  conveys  an  unwise, 
if  not  a  false,  impression  when  he  declares  in  The  Nature 
of  Man'  that  "Man  is  a  kind  of  miscarriage  of  the  ape, 
endowed  with  profound  intelligence  and  capable  of  great 
progress/'  and  exception  may  be  taken  legitimately  to  a 
deduction  of  such  sweeping  force  from  the  evidence  of  a 
certain  trifling  differentiation  of  a  'Sunset  Plant/  observed 
by  De  Vries  and  a  'Lightning  Calculator'  phenomenon. 

Man  has  no  reason  to  be  ashamed  of  his  ancestry,  and 
assuredly  there  is  reason  for  his  pride  as  he  looks  back 
upon  the  path  which  he  has  traveled  and  perceives  the 
advances  he  has  made.  Emerson  puts  the  matter  strongly 
when  he  says,  "Man  betrays  his  relation  to  what  is  below 
him,  thick-skulled,  small-brained,  fishy,  quadrumanous 
quadruped,  ill-disguised,  hardly  escaped  into  biped,  and  has 
paid  for  the  new  powers  by  the  loss  of  some  old  ones.  But 
the  lightning  which  explodes  and  fashions  planets  and 
suns  is  in  him.  On  the  one  side  elemental  order,  sand- 
stone and  granite,  rock  ledges,  peat  bog,  forest,  sea  and 
shore ;  on  the  other  part  thought  and  the  spirit  which  com- 
poses and  decomposes  nature.  Here  they  are,  side  by  side, 
god  and  devil,  mind  and  matter,  king  and  conspirator,  rid- 
ing peacefully  together  in  the  eye  and  brain  of  every  man." 

The  phrase  now  so  often  used,  "Man's  Place  in  Na- 
ture," has  become  possessed  of  value  for  the  reason  that  it 
is  evident  his  place  is  in  Nature,  not  in  any  supernatural 
realm.  He  is  part  and  parcel  of  Nature,  and  the  biological 
truths  which  apply  to  the  smallest  and  most  simple  organ- 
ism bear  a  relation  to  him,  neither  can  he  for  a  fractional 
instant  escape  from  the  domination  of  the  Draconic  laws 
that  govern  the  matter  of  which  he  is  composed.  There 
is  still  discussion  as  to  whether  the  physical  frame  of  man 
differentiated  itself  from  the  parent  mammalian  stock  at  an 


MAN'S    PLACE    IN    NATURE  7 

early  or  a  recent  date,  or  to  put  it  more  bluntly,  whether 
he  is  closely  or  distantly  related  to  the  present  apes  and 
monkeys.  That  he  is  related  is  beyond  question,  the  only 
point  needing  determination  is  the  closeness  of  the  rela- 
tionship. 

"Close  examination  of  the  structure  of  Man  has  proved, 
in  the  most  definite  fashion,"  says  Metchnikoff,  "the  exist- 


Fig.  2 — FEMALE  HOTTENTOT    AND  FEMALE  GORILLA — (Winchell). 

ence  of  a  near  kinship  with  the  higher  monkeys  or  anthro- 
poids. Now  that  all  the  details  of  the  human  organization 
have  been  studied,  and  the  anatomical  structures  of  man 
and  large  monkeys  without  tails  have  been  compared,  bone 
with  bone  and  muscle  with  muscle,  a  truly  astonishing 
analogy  between  these  organisms  is  made  manifest,  an 
analogy  apparent  in  every  detail." 

Not  less  definite  is  David  Starr  Jordan.  "We  no  longer 
think  of  the  human  race,"  he  says,  "as  a  completed  entity 
in  the  midst  of  Nature,  but  apart  from  it,  with  a  different 
origin,  a  different  motive,  a  different  destiny.  Man,  like 
the  other  species,  is  an  inhabitant  of  the  earth,  a  product 


8  ANTHROPOLOGY 

of  the  laws  of  life;  his  characters  are  phases  in  the  long 
process  of  change  and  adaptation  to  which  all  organisms 
are  subject.  From  the  point  of  view  of  zoology,  the  hu- 
man race  is  a  group  of  closely  allied  species,  or  subspecies, 
undoubtedly  derived  from  a  common  stock,  and  each  spe- 
cies in  its  ramifications  modified  by  the  forces  and  condi- 
tions included  under  the  several  heads  of  variation,  he- 
redity, segregation,  selection,  and  the  impact  of  environ- 
ment precisely  as  species  in  other  groups  are  affected. 

"It  is  clear  that  if  there  is  an  origin  of  species  through 
natural  causes  among  the  lower  animals  and  plants,  there 
is  an  origin  of  species  among  men.  If  homology  among 
animals  and  plants  is  the  stamp  of  blood  relationship,  the 
same  rule  holds  true  with  Man  as  well.  Man  is  connected 
with  the  lower  animals  by  the  most  perfect  of  homologies. 
These  are  traceable  in  every  bone  and  muscle,  in  every 
blood-vessel  and  gland,  in  every  phase  of  structure,  even 
including  those  of  the  brain  and  nervous  system.  The 
common  heredity  of  Man  with  other  vertebrate  animals 
is  as  well  established  as  any  fact  in  phylogeny  can  be." 

These  finger-posts  to  the  past  are  given  their  due  dig- 
nity by  Chas.  Darwin,  when  he  says:  "To  my  mind  it 
accords  better  with  what  we  know  of  the  laws  impressed 
on  matter  by  the  Creator,  that  the  production  and  extinc- 
tion of  the  past  and  present  inhabitants  of  the  world 
should  have  been  due  to  secondary  causes,  like  those  de- 
termining the  birth  and  death  of  an  individual.  When  I 
view  all  beings,  not  as  special  creations,  but  as  lineal  de- 
scendants of  some  few  beings  who  lived  before  the  first 
bed  of  the  Silurian  was  deposited,  they  seem  to  me  en- 
nobled. There  is  grandeur  in  this  view  of  life,  with  its 
several  powers  having  been  originally  breathed  by  the 
Creator  into  a  few  forms  or  into  one,  and  that  while  this 
planet  has  gone  cycling  on  according  to  the  fixed  law  of 
gravity,  from  so  simple  a  beginning,  endless  forms  most 
beautiful  and  most  wonderful  have  been  and  are  being 
evolved." 


MAN'S    PLACE    IN    NATURE  9 

It  has  been  the  work  of  the  biologist  to  trace  the  func- 
tions of  life  in  its  simplest  form  and  to  show  the  intimate 
relations  sustained  between  life  in  the  animal  and  vege- 
table world,  and  it  has  been  the  path  of  the  zoologist  to 
depict  the  evolution  of  higher  forms  of  animal  life  from 
the  invertebrate  to  the  vertebrate  and  within  the  latter 
division  to  the  highest  order  the  Mammals.  So,  to  com- 
plete the  picture,  it  becomes  necessary  to  point  out  that 
the  highest  mammal  treated  of  by  Comparative  Zoology, 
the  Primates,  contains  a  series,  Man,  which  possesses  as 
its  nearest  kin  the  ape. 

The  members  of  the  Genus  Homo,  or  Man,  are  struc- 
turally but  very  little  removed  from  the  anthropoid  apes. 
The  actual  differences  are  slight  and  relatively  unimpor- 
tant when  compared  with  the  vast  number  of  similarities 
that  appear.  Homologies  of  the  closest  sort  exist,  in 
which  it  is  difficult  to  name  a  single  point  of  departure.  Of 
these  the  slant  of  the  hair  on  the  arms  and  body  is  notable. 
It  is  clear,  too,  that  the  nearest  point  of  resemblance 
is  to  the  ape,  which  is  descended  from  the  old-world 
monkey  (the  American  or  Platyrrhine  are  more  diver- 
gent) and  that  the  old-world  monkey  is  descended  more 
directly  from  the  lemurs,  the  lowest  branch  of  the  pri- 
mates. Says  Jordan :  "It  is  not  supposable  that  any  living 
species  of  Man  has  sprung  from  any  extant  species  of 
anthropoid  ape,"  a  statement  which  will  be  more  heartily 
endorsed  by  anthropologists  than  will  MetchnikorFs : 
"Some  anthropoid  ape  having  at  a  certain  period  become 
varied  in  specific  characters,  produced  offspring  endowed 
with  new  properties." 

The  Simian  family  tie  is  clearly  recognised  by  Ernst 
Haeckel,  for  he  declares,  "It  is  very  difficult  to  show  why 
Man  should  not  be  classed  with  the  large  apes  in  the  same 
zoological  family.  We  all  know  a  man  from  an  ape,  but 
it  is  quite  another  thing  to  find  differences  which  are  ab- 
solute and  not  of  degree  only."  How  exceedingly  true 
this  is  becomes  evident  when  an  effort  is  made  to  deter- 


Fig.  3— HOMOLOGIES  IN  HAIR  SLANT — (Romanes). 


MAN'S    PLACE    IN    NATURE  11 

mine  the  difference  between  Man  and  Ape.  These  differ- 
ences have  been  numbered  as  four:  (i)  Erect  walk;  (2) 
extremities  variant,  especially  lower,  the  great  toe  not 
being  opposable,  the  other  toe  little  prehensile;  (3)  articu- 
late speech ;  (4)  higher  reasoning  power. 

But  the  stating  of  these  differences  reveals  how  little 
variance  there  is.  Thus  several  of  the  anthropoid  apes 
assume  the  erect  posture,  and  the  much  talked  of  "Ape- 
Man  of  Java/'  the  'Pithecanthropus  Erectus,'  was  an 
erect  ape.  The  difference  in  the  toes  is  perhaps  more 
clear,  but  the  muscles  and  tendons  which  arTord  prehensi- 
bility  in  the  ape  are  present  in  the  Man,  as  the  develop- 
ment of  grasping  power  in  the  toes  has  been  shown  by 
men  who  had  lost  their  arms  in  an  accident,  for  example ; 
while  there  are  few  who  cannot  pick  up  some  such  article 
as  a  handkerchief  from  the  floor  by  the  prehensile  grip 
of  the  toes.  Articulate  speech,  however  clear  a  distinc- 
tion, cannot  be  considered  as  a  structural  variance,  an  ob- 
jection which  is  even  more  valid  in  higher  reasoning 
power. 

Suppose  in  the  structural  comparison  the  skull  be  taken 
first.  In  the  younger  apes  rather  than  in  the  adults  is  the 
resemblance  the  most  striking.  Yet,  unexpected  as  it  would 
seem,  the  skull  of  a  young  orang-utan  presents  a  better 
facial  angle,  and  it  might  be  said  is  a  more  human  skull 
than  that  of  the  skull  of  an  Australian  Bushman.  Thus, 
in  the  illustration  given,  it  will  be  noticed  that  while  the 
facial  angle  of  the  adult  orang  is  distinctly  more  bestial 
than  that  of  the  adult  Australian,  the  young  ape's  skull 
more  closely  approximates  the  young  European  child  and 
is  far  in  advance  of  the  adult  Australian. 

This  seems  to  be  due  to  the  dentition,  for  it  is  the  coming 
of  the  second  teeth  which  produces  the  great  jaw  changes, 
throwing  forward  the  prognathism  of  the  ape.  Yet,  even 
in  this  matter,  it  can  be  pointed  out,  as  has  been  done  by 
Metchnikoff,  that  the  dentition  of  the  anthropoid  apes  is 
far  closer  to  that  of  man  than  it  is  to  that  of  the  other 


12 


ANTHROPOLOGY 


monkeys,  a  point  originally  made  with  much  detail  by 
Thos.  Huxley  and  since  strengthened  by  a  host  of  con- 
firmatory evidence. 

"Another  character,"  says  Metchnikoff,  "which  shows 
that  anthropoids  are  nearer  Man  than  other  monkeys  is 


Fig.  4 — SKULLS,  HUMAN  AND  APE 

Upper  pair  of  European  child  and  Australian  adult ;  lower  pair  of 
young  and  adult  orang-utan — (Wiedersheim). 

furnished  by  the  anatomy  of  the  sacrum.  In  monkeys  as  a 
whole  the  sacrum  is  composed  of  three,  or  rarely  four 
vertebrae,  while  in  anthropoid  apes  it  contains  five;  that 
is  to  say,  just  as  many  as  in  Man. 

"The  believers  in  the  doctrine  that  the  human  species  is 


MAN'S    PLACE    IN    NATURE  13 

essentially  different  from  all  the  known  monkeys  have 
laid  great  stress  on  the  difference  between  the  foot  of 
Man  and  that  of  the  anthropoid  apes.  This  difference 
cannot  be  denied.  Man  assumes  the  erect  posture  habitu- 
ally, while  monkeys,  even  the  highest  of  them,  walk  on 
two  legs  only  occasionally.  There  has  followed  from  this 
a  greater  development  of  the  feet  in  monkeys.  Yet  this 
difference  ought  not  to  be  exaggerated.  It  has  been 
sought  to  prove  that  monkeys  are  'quadrumanous'  and  that 
their  hind-legs  terminate  in  'hind-hands.'  But  it  is  clearly 
shown  that  in  all  essential  respects  the  hinder  limb  of  the 
gorilla  terminates  in  as  true  a  foot  as  that  of  Man." 
Huxley  is  equally  assured  when  he  says :  "The  hind  limb 
of  a  gorilla,  therefore,  ends  in  a  true  foot,  with  a  very 
movable  great  toe.  It  is  a  prehensile  foot,  indeed,  but  it 
is  in  no  sense  a  hand ;  it  is  a  foot  which  differs  from  that 
of  Man  not  in  any  fundamental  character,  but  in  mere 
proportions,  in  the  degree  of  mobility  and  in  the  sec- 
ondary arrangement  of  its  parts." 

All  the  arguments  dealing  with  structural  affinity  are 
so  well  worn  that  it  is  useless  to  recapitulate  them,  but  it 
is  a  matter  of  vital  interest  when  entirely  new  lines  of 
argument,  unknown  to  Darwin,  Vogt,  and  even  Haeckel, 
come  to  light  and  are  found  to  be  confirmatory  of  the 
work  that  they  had  done.  These  two  lines  of  comparison 
are  found  in  the  embryological  affinity  between  the  anthro- 
poids and  Man  and  the  behavior  of  the  serum  of  the 
blood  of  these  two  mammals.  It  is  quite  readily  seen  that 
embryos  of  the  anthropoid  apes  are  extremely  difficult  to 
obtain,  and  it  is  only  very  recently  that  M.  Deniker  se- 
cured a  late  fetus  of  a  gorilla,  the  study  of  which  has 
elicited  many  important  evidences  of  homology. 

"The  placenta,"  comments  Metchnikoff,  "often  gives 
information  of  great  importance  in  the  classification  of 
mammals.  It  is  sufficient  to  glance  at  the  zonary  placenta 
of  dogs  and  seals  to  be  convinced  of  the  relationship  of 
these  two  species,  which  at  first  sight  seem  so  different. 


14  ANTHROPOLOGY 

Now  the  placentas  of  all  the  anthropoid  apes  examined  up 
to  the  present  (1909)  are  of  the  same  discoid  type  as  that 
of  Man.  The  arrangement  of  the  umbilical  cord  of  Man, 
which  was  formerly  considered  as  quite  peculiar  to  him, 
is  found  in  the  anthropoid  apes,  as  has  been  established 
by  Deniker  and  Selenka.  It  is  striking  that  the  anthro- 
poids resemble  Man  rather  than  the  lower  monkeys  in  the 
relation  of  the  fetus  to  the  fetal  membranes. 


Fig.  5 — FETUS  OF  GIBBON  APE — (Selenka). 

"With  regard  to  the  embryos  themselves,  the  similarity 
between  those  of  monkeys  and  of  man  is  very  great. 
Selenka  insists  on  the  fact  that  the  youngest  stages  of 
human  development  that  have  been  obtained  can  hardly 
be  distinguished  from  those  of  the  lower  monkeys  either 
in  position  or  in  shape.  More  advanced  stages  exhibit 
greater  differentiation,  and  the  later  embryos  of  Man 
resemble  anthropoids  much  more  closely  than  those  of  the 


MAN'S    PLACE    IN    NATURE  15 

lower  monkeys.  The  fetus  of  the  gibbon  presents  the 
most  striking  likeness  to  a  corresponding  human  fetus." 
With  the  line  in  structural  development  and  the  embryo- 
logical  history  so  clearly  adduced,  nothing  more  could  be 
needed.  Still,  the  differences  which  do  exist  begin  early 
in  the  fetal  life,  showing  that  the  branching  must  have 
been  long  before  the  development  of  the  true  ape. 


Fig.    6 — HUMAN    FETUS    NEARLY    FOUR    MONTHS    OLD — (Metch- 
nikoff). 

When,  however,  so  essentially  recent  and  conspicu- 
ously definite  a  discovery  as  that  with  regard  to  the 
serum  is  made,  it  may  not  be  regarded  as  too  repetition- 
ary.  The  passages  dealing  with  this  again  are  taken  from 
MetchnikofFs  'Nature  of  Man'  for  the  reason  of  its  pro- 
curability,  as  well  as  the  knowledge  that  facts  cited  therein 


16  ANTHROPOLOGY 

would  be  authoritative,  however  widely  the  reader  might 
dissent  from  the  conclusions  drawn  from  those  facts. 

"When  the  blood  of  one  mammal  is  injected  into  the 
body  of  another,  the  latter  shows  some  remarkable  modi- 
fications. When  there  is  added  to  a  serum,  prepared  from 
the  blood  of  a  rabbit,  and  consisting  of  a  colorless  trans- 
parent liquid,  a  few  drops  of  blood  drawn  from  another 
rodent  (such  as  a  guinea-pig),  nothing  unusual  happens. 
The  blood  of  the  guinea-pig  preserves  its  normal  color, 
and  its  corpuscles  remain  practically  unaltered.  If,  in- 
stead of  adding  guinea-pig's  blood  to  the  serum  of  rabbit's 
blood,  we  add  a  serum  drawn  from  the  blood  of  the 
guinea-pig,  still  no  special  change  occurs. 

"If,  however,  a  serum  be  prepared  from  the  blood  of  a 
rabbit  into  which  there  had  first  been  injected  the  blood  of 
a  guinea-pig,  the  serum  shows  new  and  striking  qualities. 
The  addition  to  it  of  some  drops  of  guinea-pig's  blood 
brings  about,  in  a  very  short  time,  a  changed  appearance. 
The  red  liquid,  at  first  opaque,  becomes  transparent.  The 
mixture  of  the  prepared  serum  of  the  rabbit  with  the  blood 
of  the  guinea-pig  will  assume  the  color  of  claret  mixed 
with  water.  The  change  is  due  to  solution  of  the  red  cor- 
puscles of  the  guinea-pig  in  the  blood-serum  of  the  rabbit. 

"This  serum  has  still  another  property  not  less  worthy 
of  attention.  If  there  is  added  to  it  not  pure  blood,  but 
only  blood  serum  of  the  guinea-pig,  a  disturbance  in  the 
mixture  occurs  almost  at  once,  and  leads  to  the  forming 
of  a  precipitate  more  or  less  abundant.  The  injection  of 
the  blood  of  the  guinea-pig  into  a  rabbit  has  therefore 
changed  the  serum  of  the  latter  by  introducing  new  prop- 
erties :  that  of  dissolving  the  red  corpuscles  of  the  guinea-- 
pig and  of  giving  a  precipitate  with  the  blood  serum  of 
the  same  animal. 

"Frequently  the  blood  serum  of  animals  prepared  by 
previous  injections  of  the  blood  of  other  species  of  ani- 
mals is  strictly  specific.  In  such  cases  the  serum  only 
gives  a  precipitate  with  the  serum  of  the  species  which 


MAN'S    PLACE    IN    NATURE 


has  furnished  the  blood  for  the  injections  and  only  dis- 
solves the  red  corpuscles  of  this  same  species.  But  there 
are  some  instances  in  which  a  serum  of  a  prepared  animal 


Fig.   7 — EXTREMITIES  OF   HUMAN  AND  GORILLA  FETUS 

Showing  differentiation  early  in  the  life  of  individual,  a,  Hand  of 
human  embryo ;  b,  foot  of  same ;  c,  hand  of  gorilla ;  d,  foot 
of  same — (Langley). 

dissolves,  not  only  the  red  corpuscles  of  the  species  which 
has  furnished  the  injected  blood,  but  those  of  allied  spe- 
cies. Thus  the  blood  serum  of  the  rabbit,  after  some  in- 


i8  ANTHROPOLOGY 

jections  of  blood  of  the  chicken,  becomes  capable  of  dis- 
solving not  only  the  red  corpuscles  of  the  chicken,  but  also 
those  of  the  pigeon,  tho  in  a  less  degree. 

"Until  quite  recently  it  was  not  known  how  to  distin- 
guish human  blood  from  that  of  other  mammals.  (It  is 
a  question  that  often  arises  in  a  court  of  law,  particularly 
in  criminal  law).  It  is  now  found  that  the  method  of 
precipitates  gives  conclusive  results.  It  is  done  in  this 
way:  Human  blood  is  injected  several  times  into  any  ani- 
mal (rabbit,  dog,  sheep,  horse).  Some  time  afterward  the 
animal  is  bled,  and  a  clear  and  limpid  serum,  quite  devoid 
of  corpuscles,  is  prepared.  When  there  is  added  to  this 
serum  one  or  several  drops  of  human  serum,  it  forms  im- 
mediately a  precipitate  which  falls  to  the  bottom.  In  this 
way  it  is  discovered  whether  the  prepared  serum  is  suffi- 
ciently active.  It  then  becomes  possible  to  recognise  even 
dried  human  blood.  A  little  of  such  blood  is  dissolved  in 
normal  salt  solution  and  placed  in  a  tube  containing  the 
serum  of  an  animal  prepared  by  means  of  injections  of 
human  blood.  If  a  precipitate  forms  in  the  liquid  in  a 
short  time,  the  fact  indicates  that  the  stain  is  really  human 
blood.  This  method  is  being  practiced  in  forensic  medi- 
cine. 

"How  does  the  serum  of  animals  which  have  been  in- 
jected with  human  blood  behave?  The  serum  capable  of 
giving  a  precipitate  with  human  serum  does  not  produce 
the  same  reaction  except  with  the  serum  of  some  monkeys 
(the  small  Papio). 

"Gruenbaum,  of  Liverpool,  has  been  fortunate  enough 
to  procure  a  considerable  quantity  of  the  blood  of  three 
large  anthropoid  apes — the  gorilla,  chimpanzee  and  orang- 
utan. He  has  been  able  to  prove  that  the  serum  of  animals 
injected  with  Man's  blood  gives  a  precipitate  not  only 
with  this  blood,  but  also  with  that  of  the  above-mentioned 
apes.  It  was  impossible  for  him  'to  distinguish  this  pre- 
cipitate as  regards  quality  and  quantity  from  that  which 
is  obtained  with  human  blood/ 


MAN'S    PLACE    IN    NATURE  19 

"To  verify  this  result,  Gruenbaum  prepared  the  serum 
of  animals  injected  with  the  blood  of  the  gorilla,  chim- 
panzee and  orang-utan.  These  three  kinds  of  serum  gave 
precipitates  with  the  blood  of  these  three  apes  and  to  the 
same  extent  with  the  blood  of  Man.  It  is  therefore  evident 
that  there  exists  between  the  human  species  and  the  an- 
thropoid apes  not  only  a  superficial  analogy  of  body  and 
the  principal  organs,  but  a  close  blood-relationship." 

To  add  further  evidence  would  be  gratuitous,  for  the 
human  being  is  truly  the  present  ultimate  of  evolution — 
so  far  as  he  can  grasp  it. 

But  Man  as  he  is  to-day  will  not  endure.  There  are 
constant  modifications  proceeding  in  him,  physical  and 
mental,  each  with  reflex  action  on  the  other.  Nothing  he 
knows  endures;  the  mountain  is  no  more  nearly  eternal 
than  the  castle  of  sand  the  child  builds  upon  the  beach 
between  the  low  tide  and  the  high  tide  marks.  "I  believe," 
said  the  rose  to  the  lily  in  the  parable,  "that  our  gardener 
is  immortal.  I  have  watched  him  from  day  to  day  since  I 
bloomed,  and  I  see  no  change  in  him.  The  tulip  who  died 
yesterday  told  me  the  same  thing." 

The  Science  of  Anthropology,  then,  must  hark  back  to 
the  earlier  mammalian  stock  for  its  beginning,  must  con- 
sider all  races  of  men  at  the  present  day  for  its  momentary 
review,  and  must  cast  a  prophetic  glance  forward  to  dis- 
cern what  Man  shall  become.  Its  economic  value  lies  in 
determining  what  are  the  lines  of  direction  progress  is 
taking  and  in  pointing  out  the  manner  to  follow  those  lines, 
to  the  end  that  Nature  may  be  rightly  helped,  not  hin- 
dered. Not  that  Nature  needs  help,  but  that  Man,  if  he 
ignorantly  endeavors  to  pursue  a  path  not  intended  for  his 
feet,  first  will  suffer  cruelly  and  at  the  last  be  cast  aside. 


CHAPTER  II 

ANTHROPOMETRY 

IT  is  an  idiom  of  general  use  to  declare  that  a  particular 
person  'has  the  ear-marks'  of  a  certain  definite  type,  and 
while  this  phrase  probably  has  evolved  in  America  from 
the  ear-marking  of  cattle  in  the  West,  yet  it  is  not  the  less 
true  in  a  nearer  instance  that  might  be  given.  For  ear- 
marks are  indeed  one  of  the  many  definite  measurements 
which  are  not  only  peculiar  to  Man  as  a  whole  but  to  the 
individual  man. 

It  may,  perhaps,  be  going  too  far  to  say  that  the  study 
of  Anthropometry  is  one  wherein  every  person  is  a  scholar, 
but  none  the  less  it  is  most  amazingly  true  that  the  actions 
of  men's  lives  are  modified  by  their  intuitive  or  experi- 
ence-taught understanding  of  the  measurements  of  their 
fellow-beings.  It  has  been  wisely  said  that  "had  Cleo- 
patra's nose  been  a  little  shorter  it  would  have  changed 
the  map  of  Europe,"  and  it  seems  not  less  likely  to  be  true 
that  had  it  been  a  trifler  longer  the  same  effect  would  have 
been  apparent.  Had  Helen  of  Troy  possessed  a  cast  in  the 
eye,  where  would  have  been  the  Iliad  and  the  Odyssey, 
and  would  there  have  been  the  chivalrous  loyalty  in  the 
court*of  Elizabeth  if  the  Virgin  Queen  had  been  a  sour- 
visaged  shrew?  Yet  it  must  be  admitted  that  between 
supernal  beauty  and  eldritch  ugliness  is  but  the  fraction  of 
an  inch  here  or  there. 

Before  going  into  the  more  scientific  measurements  and 
their  implications,  it  may  be  well  to  show  that  there  are 


ANTHROPOMETRY  21 

certain  of  these  which  are  indubitably  familiar  to  every 
observer.  Thus  a  man  who  cannot  look  you  squarely  'be- 
tween the  eyes' — that  is,  whose  eye  muscles  are  not  suffi- 
ciently under  control  to  meet  your  gaze — will  rarely  be 
trusted.  He  is  thought  (and  often  rightly)  evasive,  under- 
hand and  untrustworthy.  Where  the  eyes  are  large  and 
lustrous  an  affectionate  disposition  is  expected,  when  they 
are  steely  blue  and  extremely  rapid  in  their  glances  from 
object  to  object,  quickness  of  wit  and  instancy  of  decision 
are  encountered. 

How  generally  are  the  measurements  of  the  lips  taken 
in  such  hasty  decisions.  Ripe,  red  lips,  moist  and  partly 
open,  seem  to  convey  an  invitation  to  dalliance  which  is 
certainly  absent  in  the  thin,  hard,  dry  line  of  the  angular 
and  embittered  spinster.  Likewise  a  mouth  kept  partly 
open  most  of  the  while  is  often  a  sign  of  vacuity  of  mind 
and  uncomprehending  surprise,  while  a  firm,  determined 
set  of  the  lips  and  of  the  chin  reveals  a  character  thoroly 
comprehending  the  goal  sought  and  insistent  on  securing 
the  point  of  attainment  sought.  In  contrast  to  this,  again, 
the  receding  chin  is  taken  to  imply  mental  weakness  and 
lack  of  purpose. 

So  a  low,  receding  forehead  and  a  development  of  the 
back  of  the  head  is  so  well  known  that  in  common  speech 
it  is  called  a  'criminal  head/  while  if  it  be  coupled  to  a 
mowing  of  the  jaw  and  a  certain  glassy  stare  in  the  eyes 
it  is  interpretative  of  some  forms  of  idiocy.  Even  the 
eyebrows  play  their  part,  and  it  is  familiar  to  hear  of 
frowning  eyebrows  implying  fierceness  of  temper,  of 
supercilious  eyebrows  implying  a  character  prone  to  the 
use  of  the  critical  faculty,  and  tilted  eyebrows  are  often 
esteemed  the  sign  of  an  unready  nature.  The  list  could 
be  multiplied  to  great  length,  and  these  merely  have  been 
mentioned,  not  in  the  sense  that  scientifically  speaking 
they  do  really  portray  the  characters  to  which  they  have 
been  assigned,  but  to  show  that  a  relation  of  character  to 
physical  measurement  is  popularly  assigned. 


22  ANTHROPOLOGY 

A  still  more  striking  evidence  of  this  is  seen  in  the 
matter  of  resemblances.  The  actual  variances  of  measure- 
ment between  two  brothers  or  two  sisters  often  are  very 
slight — so  far  as  the  face  goes,  they  require  the  most  exact 
instruments  to  record  them;  yet  the  eye  at  the  same  time 
perceives  a  similarity  and  a  difference.  But  for  this  abil- 
ity of  the  eye  to  grasp  readily  the  infinitesimal  differences 
in  features,  all  family  life  would  come  to  a  standstill;  the 
husband  would  not  know  the  wife  nor  the  wife  the  hus- 
band, and  neither  children  nor  parents  could  be  sure  of 
their  relationship. 

Commerce  and  trade  would  come  largely  to  a  standstill, 
for  there  could  be  no  system  of  credit  if  the  buyer  and  the 
seller  were  unable  to  recognise  each  other.  It  forms  an 
interesting  speculation,  indeed,  to  try  and  devise  a  world 
which  should  be  in  all  respects  as  this,  yet  lacking  the 
anthropometrical  sense.  It  is  certain  that  it  would  modify 
profoundly  the  civilization  of  to-day. 

The  race  question  would  take  on  a  new  aspect,  for 
gradations  of  color  really  belong  to  anthropometry  and 
certainly  physiognomic  comparison  also.  The  Chinaman 
and  the  Negro  and  the  Caucasian  are  easily  told  apart,  but 
only  because  of  color  and  of  measurement.  Nay,  even 
the  difference  between  a  man  and  an  ape,  between  an  ape 
and  a  dog  and  so  forth  are  again  merely  matters  of  meas- 
urement. 

In  Ethnology,  generally,  no  little  use  will  be  made  of  an- 
thropometrical measurements,  for  the  reason  that  they 
afford  a  true  basis  for  divisions  of  races.  Thus  the 
oblique  slant  of  the  eyes  is  a  Mongolian  sign,  the  progna- 
tous  jaws  and  intumescent  lips  reveal  the  Negro,  and  the 
high  facial  angle  indicates  the  Caucasian.  To  touch  on 
other  structural  differences,  may  be  mentioned  the  well- 
known  facts  of  the  greater  length  of  arms  among  the  ne- 
groes and  the  hindward  projection  of  the  heel  in  a  manner 
similar  to  that  of  the  anthropoid  apes. 

Of  recent  years,  however,  a  new  value  has  been  given 


ANTHROPOMETRY  23 

to  anthropometry  by  its  use  in  criminology,  or  the  dealing 
with  the  various  types  of  criminals  that  infest  society. 
This,  because  it  has  been  carried  to  its  highest  degree  of 
efficiency,  as  well  as  because  most  of  the  origination  and 
development  of  the  plan  was  done  by  Alphonse  Bertillon, 
is  known  as  the  Bertillon  system. 

An  admirer  of  Bertillon,  Prof.  Persifor  Frazer,  in  a 
recent  article  (1909)  in  the  Journal  of  the  Franklin  Insti- 
tute, has  gone  so  far  as  to  declare  that  the  system  is  the 
answer  to  the  question,  "Of  what  use  is  Anthropology?" 
This  is  an  extreme  viewpoint,  for  Anthropology  has  a 
score  of  other  avenues  of  economic  value,  but  it  contains 
enough  truth  to  point  out  the  exceeding  value  of  such 
measurements  in  Criminology.  Indeed,  it  lies  entirely 
within  the  purview  of  this  subject  to  give  a  brief  sketch 
of  the  Bertillon  system,  its  nature  and  its  mode  of  opera- 
tion. 

If  the  aphorism  be  true  that  'genius  is  the  capacity  to 
take  infinite  pains/  Bertillonage  is  an  example  of  the  high- 
est genius,  for  its  successful  application  depends  upon  a 
delicate  unperturbed  appreciation  of  physical  sensations 
on  the  part  of  the  observer,  a  scrupulous  accuracy  in  re- 
cording observable  data,  and  the  use  of  all  the  precautions 
known  to  original  investigation  by  repetition  of  measure- 
ments and  readings  to  avoid  possible  error. 

Broca,  a  member  of  the  first  Societe  d'Anthropologie,  of 
Paris,  proposed  a  color  scale  for  describing  the  eyes  and 
skin  of  different  races  of  men.  The  characteristics  which 
he  regarded  as  most  valuable  in  distinguishing  races  were, 
first,  the  color  of  the  skin,  and,  second,  the  structure  of  the 
skull,  and  their  importance  in  the  order  given. 

According  to  Retzius'  method,  very  generally  adopted 
by  anthropologists,  the  longer  diameter  of  the  skull  from 
front  to  back  is  assumed  as  100.  If  the  shorter  diameter 
measured  above  the  ears  is  less  than  80  on  this  scale,  the 
skull  is  called  dolichocephalic  (long-narrow  headed)  ;  if 
more  than  80,  brachycephalic  (short  or  round  headed). 


24  ANTHROPOLOGY 

From  75  to  80  in  the  transverse  diameter  he  called  meso- 
cephalic.  Negroes  have  72,  Europeans  78,  and  Tartars 
88,  in  this  measure.  The  application  by  M.  Bertillon  of 
these  methods  was  for  the  identification,  not  of  great 
groups  of  the  human  family — races — from  each  other, 
but  of  an  individual  from  every  other  individual,  and  arose 
from  the  urgent  need  of  the  law  courts  to  know  whether 
they  were  dealing  with  old  offenders  (recedevistes),  or 
whether  an  arrested  man  actually  had  not  been  previously 
before  them. 

M.  Bertillon's  system  is  divided  into,  first,  a  means  of 
identifying  an  individual  with  absolute  certainty,  from 
careful  measurements  taken  by  skilled  agents,  and,  second, 
a  ready  means  of  recognising  an  individual  in  a  crowd 
from  a  description  or  from  observations  previously  taken. 
One  supplements  the  other,  while  each  is  useful  independ- 
ently of  the  other. 

The  principle  upon  which  the  measurements  are  based 
is  that  no  things  are  absolutely  identical,  however  similar 
they  may  seem.  This  is  especially  true  of  organic  objects 
which  grow,  because  it  is  unthinkable  that  two  different 
and  separate  beings  could  be,  during  a  number  of  years, 
subjected  to  exactly  the  same  forces,  and  should  present 
to  these  forces  exactly  the  same  resistances.  Whatever  it 
be,  whether  two  coins  struck  from  the  same  die,  twins  who 
have  been  fed  and  nurtured  similarly,  even  two  drops  of 
water  taken  from  the  same  source,  a  sufficiently  minute  ex- 
amination will  inevitably  disclose  differences  which  will  be 
greater  and  more  numerous  the  more  searching  and  careful 
is  the  investigation.  It  is  only  necessary  then  to  obtain  a 
sufficient  number  of  data  from  each  individual  to  place 
upon  record  a  description  which  will  differ  from  that  of 
any  other  individual  analogously  made. 

This  identification  is  confined  to  the  two  measurements 
of  the  head  with  callipers  fixed  successively  to  the  figures 
given  in  the  description  already  on  file.  These  two  data 
taken  and  corroborated  to  a  millimeter  (y»  inch)  are 


ANTHROPOMETRY  25 

amply  sufficient  to  determine  whether  or  not  the  prisoner 
has  told  the  truth.  It  is  thus  at  once  seen  whether  the  same 
individual  is  present,  and  if  so  no  further  measurement  is 
made.  When  the  same  offender  has  been  identified  five 
times  he  is  banished. 

As  rapidly  as  possible  those  wfio  are  subjected  to  a 
further  examination  are  called  into  the  large  adjoining* 
room  where  three  separate  sets  of  measurements  can  be 
undertaken  at  the  same  time.  In  each  case  the  same  agent 
obtains  the  following  anthropometric  measurements,  the 
portrait  parle  description,  and  the  peculiarly  characteristic 
marks,  which  are  recorded  by  a  clerk  occupying  an  ele- 
vated desk  very  much  as  the  measurements  are  taken  in 
the  better  class  of  tailor  shops. 

The  Long  Diameter  of  the  Skull. — This  is  obtained  by 
means  of  adjustable  callipers  with  a  binding  screw  to  fix 
the  arms  at  any  position.  The  measure  is  made  from  the 
cavity  at  the  root  of  the  nose  to  the  point  of  greatest  pro- 
tuberance of  the  occiput.  Two  measures  are  made  to  con- 
trol each  other. 

Transverse  Diameter  of  the  Skull. — This  is  taken  by 
means  of  the  same  callipers  and  is  the  maximum  distance 
apart  of  the  parietal  bones  which  are  situated  above  the 
superior  border  of  each  ear. 

The  length  of  the  middle  finger,  the  span  with  both  arms 
outstretched,  the  length  of  the  left  forearm,  the  height,  the 
height  of  the  trunk  and  the  length  of  the  ear  are  all  deter- 
mined. The  Bi-zygomatic  Diameter  has  in  part  replaced 
that  of  the  right  ear.  It  is  taken  by  means  of  the  same 
callipers,  between  the  osseous  bands  which  terminate  above 
the  auditory  canal  and  behind  the  cheek  bones.  In  French 
adults  it  varies  between  137  mm.  and  138  mm.  (about  5.39 
inches). 

"It  is  evident  at  the  first  thought,"  says  Prof.  Frazer, 
"that  the  most  permanent  data  will  be  found  in  those  parts 
of  the  body  which  undergo  the  least  change;  in  other 
words,  the  bony  structure ;  and  of  all  these  the  skull,  which 


26  ANTHROPOLOGY 

from  an  early  age,  in  spite  of  its  twenty-two  component 
bone-plates,  is  virtually  a  single  large  bone,  proves  the 
most  available  for  identification  because  important  ar- 
tificial alteration  of  its  dimensions  is  almost  or  quite  im- 
possible." (The  skull  of  the  adult  of  course  is  referred 
to  here,  as  the  savage  deformations  of  the  skull  are  done 
in  childhood.)  The  pivotal  point  of  the  Bertillon  meas- 
urements is  therefore  the  skull  and  the  relation  to  each 
other  of  its  anteroposterior  and  transverse  diameters. 

Two  other  means  of  identification  of  the  highest  impor- 
tance have  been  added  to  the  anthropometric  measure- 
ments of  M.  Bertillon,  the  finger-prints  and  the  shades  of 
color  in  the  eye. 

The  study  of  the  finger-prints  is  perhaps  the  most  pic- 
turesque of  all  the  Bertillon  points.  It  is  an  addition  to 
the  system  and  is  so  recognised,  and  the  credit  seems  to  be 
assigned  to  Sir  William  Herschel  when  he  was  Collector 
of  a  district  in  Bengal.  Altho  it  was  handled  there  in 
modern  methods,  the  true  importance  of  it  did  not  ap- 
pear until  1888  when  Francis  Galton,  having  given  it  ex- 
tensive study,  announced  to  the  scientific  world  the  con- 
spicuous value  of  the  system  and  illustrated  his  arguments 
with  examples  that  allowed  of  no  further  question.  The 
setting  forth  was  exhaustive  and  conclusive. 

Altho  Galton  is  on  record  as  having  said  that  his  at- 
tention was  drawn  to  the  matter  by  a  personal  investiga- 
tion of  the  Bertillon  system,  the  French  bureau  for  some 
years  paid  no  attention  to  it  until  M.  Bertillon  saw  that  it 
would  afford  an  absolutely  final  support  in  the  verification 
of  criminals.  Galton's  system  was  slightly  modified,  and 
a  nomenclature  and  method  arranged  which  is  now  com- 
plete in  every  detail.  To  this  end  the  four  vowels  "e,"  "i," 
"o,"  and  "u"  are  used  to  indicate  the  four  types  into  which 
the  patterns  of  the  finger  prints  are  divided.  Loops  resting 
on  the  usual  triangle  of  intersection  near  the  middle  of 
the  impression  extend  from  left  to  right  downward;  their 
closed  ends  being  above  and  to  the  left,  and  the  free  ends 


ANTHROPOMETRY 


27 


descending  to  the  right.     To  justify  the  designation  there 
must  be  at  least  two  such  loops. 

The  type  "i"  is  that  pattern  where  at  least  two  ridges 
indicated  by  black  lines  in  the  impression  have  their  closed 


A  . 


Tt^ 


*\(J-)~~ 

— Usse*^     .'*  v 


ft) 


Fig.  8 — TYPES  OF  FINGER  PRINT  PATTERNS 

ends  to  the  right,  above  the  triangular  places  of  intersec- 
tion, forming  an  oval,  or  spiral,  the  latter  either  concentric 
or  as  volute. 

The  type  "o"  is  that  where  the  digital  lines  appear  to 
the  number  of  at  least  4  between  the  little  triangular  pat- 


28  ANTHROPOLOGY 

terns  marking  the  central  point  of  each  finger  tip ;  and  their 
form  is  oval,  spiral,  or  volute. 

The  type  "u"  is  that  pattern  in  which  the  lines  are  super- 
posed in  the  form  of  an  arch,  flat  near  the  bottom  and 
higher  on  top. 

An  interesting  practical  application  of  this  method  ap- 
peared in  the  mysterious  Steinheil-Japy  murder  case  which 
had  been  agitating  Paris  in  the  winter  of  1908.  In  this 
instance  the  invisible  network  of  greasy  exudation  from 
the  papillary  ridges  of  various  hands  which  grasped  a  bot- 
tle of  cognac  had  been  traced  to  the  possessors  of  these 
hands,  the  prints  being  dusted  with  finely  powdered  white 
lead. 

Another  case,  taken  at  random  among  thousands,  was 
as  follows :  On  April  30,  1906,  a  man  was  arrested  and 
measured  under  the  name  of  Giard.  On  September  4, 
1908,  a  prisoner  was  measured,  giving  his  name  as  Giraut. 
Tho  27,739  persons  had  been  measured  in  the  interval  he 
was  identified  by  the  finger-prints  in  less  than  five  minutes. 

The  Examination  of  the  Left  Eye. — The  eye  is  a  means 
of  identification  as  important,  in  M.  Bertillon's  estimation, 
as  the  marks  of  the  finger  prints.  The  color  does  not 
change  with  age.  So  far  as  its  color  is  concerned,  M.  Ber- 
tillon  asserts,  the  eye  is  unchangeable  from  birth  to  death. 
M.  Bertillon  has  made  a  table  of  seven  categories  of  color. 
The  categories  are  based  on  the  increasing  intensity  of  the 
yellow-orange  pigment-  The  pigment  is  a  reddish  or 
brownish  yellow  animal  matter  which  gives  to  the  eye 
diverse  tints.  When  the  pigment  increases  in  quantity  in 
an  iris,  the  eye  from  the  point  of  view  of  its  color,  and  of 
the  number  in  its  class,  increases  also. 

In  other  words,  the  more  pigment  an  eye  contains  the 
more  it  appears  dark,  and  close  to  the  extreme  type  of 
pure  horse-chestnut  color.  Eyes  called  unpigmented  are 
not  deprived  of  all  color,  but  are  uniformly  blue,  and  the 
opposites  of  the  pure  horse-chestnut  brown  color.  This 
type  of  eye  is  found  among  the  Slavs  and  the  people  of  the 


ANTHROPOMETRY 


29 


North,  the  other  type  among  the  negroes,  the  Arabs,  and 
more  generally  the  dwellers  in  the  South. 

The  function  of  the  anthropometric  service  is  to  obtain 
from  the  prisoners  brought  to  it  a  certain  number  of  os- 
seous measurements,  using  the  figures  thus  obtained  as  a 
basis  to  classify  the  photographs  of  individuals,  after  the 
manner  of  a  classification  of  flora,  etc.,  to  enable  one  ulti- 


Fig.  9 — RECORD  OF  CRIMINAL'S  IDENTIFICATION — (Fraser). 

mately  to  find,  in  a  collection  destined  to  contain  several 
hundred  thousand  specimens,  the  portrait  of  an  old  offender 
who  has  concealed  his  identity  under  a  false  name  and  a 
disguise. 

Suppose  the  collection  to  contain  sixty  thousand  records. 
The  first  division  is  based  on  the  longer  diameter  of  the 
skull.  In  all  cases  the  order  is  from  small  to  great.  Then 


30  ANTHROPOLOGY 

the  division  containing  records  of  these  would  be:  short 
heads,  20,000;  medium  heads,  20,000;  long  heads,  20,000. 

Each  of  these  three  divisions  of  20,000  is  further  divided 
into:  narrow  heads,  6,000;  medium  heads,  6,000;  broad 
heads,  6,000. 

Each  of  these  three  divisions  of  6,000  is  further  sub- 
divided into:  long  middle  fingers,  2,000;  medium  middle 
fingers,  2,000 ;  short  middle  fingers,  2,000. 

Each  of  these  last  divisions  of  2,000  is  further  subdivided 
into:  short  left  foot,  600;  medium  left  foot,  600;  long  left 
foot,  600. 

These  again  into:  long  left  forearm,  200;  medium  left 
forearm,  200;  short  left  forearm,  200. 

These  further  into:  small  little  finger,  60;  medium  little 
finger,  60 ;  long  little  finger,  60. 

These  into:  long  right  ear,  20;  medium  right  ear,  20; 
short  right  ear,  20. 

These  into  heights :  short,  6 ;  medium,  6 ;  tall,  6,  and  these 
six  remaining  from  the  60,000  original  cases  are  further 
differentiated  by  the  color  of  the  eyes.  So  that  but  a  few 
minutes  would  elapse  from  the  first  glance  into  the  head- 
length  box  till  the  agent  had  traced  the  individual  whose 
record-slip  was  given  to  him  down  to  the  ear-division,  and 
selected  by  the  eye-color  determination  which  of  the  six 
slips  if  any  correspond  to  that  in  his  hand. 

When  in  addition  the  finger  prints  are  available,  it  is 
clear  that  possibility  of  mistake  is  eliminated.  In  more 
than  2,300  recognitions  thus  transmitted  to  the  trial  mag- 
istrates not  a  single  one  has  caused  the  confusion  or  em- 
barrassment which  a  mistake  would  have  been  sure  to  oc- 
casion. 

M.  Bertillon  has  strictly  forbidden  his  employees  to  in- 
form the  interested  individual  when  he  has  been  identified. 
A  few  notes  are  taken  and  he  is  dismissed  to  the  depot,  but 
the  facts  are  put  into  the  possession  of  the  magistrate  who 
is  to  try  him,  and  this  will  explain  the  frequent  dramatic 
sensations  produced.  The  prisoner  is  arraigned  before  the 


ANTHROPOMETRY  31 

magistrate.  He  has  answered  that  his  name  is  Jean  Bour- 
det,  a  carpenter,  living  in  the  Rue  Mesnil,  that  he  is  un- 
married, and  twenty-four  years  old.  Whereupon  the  genial 
justice  replies:  "Your  name  is  Eugene  Tridot;  you  were 
arrested  for  highway  robbery  and  attempted  assassination 
on  June  17,  1902;  you  were  also  imprisoned  for  beating 
your  wife  almost  to  death;  you  were  born  in  Lyons,  are 
thirty-seven  years  old  and  have  served  three  terms  of  im- 
prisonment; this  is  your  fourth  appearance  and  last 
chance;  your  present  punishment  must  bear  relation  to 
your  former  crimes,  and  if  you  are  ever  again  in  the  hands 
of  justice,  banishment  inevitably  will  follow." 

Professor  Frazer  touches  a  point  of  vast  importance 
when  he  reveals  the  potency  of  the  Bertillon  system  not 
only  in  identifying  criminals,  but  in  convincing  offenders 
against  society  that  recognition  is  inevitable  and  penalty 
swift  and  sure;  while,  even  more  than  this,  it  becomes  a 
most  efficacious  prevention  of  crime.  When  it  is  no  longer 
possible  to  dodge  the  law,  illegality  diminishes.  Again, 
the  same  writer  points  out:  "If  the  identification  be  so  per- 
fected, and  so  universally  adopted,  that  recognition  of  a 
person  who  has  been  Bertillonized  is  positively  certain, 
will  it  not  be  possible  so  to  modify  the  penal  legislation 
that  the  trials  and  condemnations  of  criminals  shall  pro- 
ceed to  their  ultimate  punishment  of  the  guilty  without  the 
use  of  names  at  all?  In  this  way  the  innocent  parents, 
brothers  and  sisters  of  a  degenerate  may  be  spared  the 
added  humiliation  and  suffering  of  seeing  the  name  they 
bear  and  have  tried  to  make  honorable  associated  with 
some  revolting  or  contemptible  crime." 

This  is  but  one  of  the  avenues  of  advancement  which 
the  study  of  Anthropometry  affords.  It  possesses  especial 
force  because  of  its  practical  nature  and  the  intense 
amount  of  energy  inherent  to  it  in  the  suppression  of 
crime,  in  the  advancement  of  civilization  and  in  the  gen- 
eral welfare  of  mankind. 


CHAPTER  III 

THE   UNITY   AND  THE   VARIETY   OF    MAN 

RACE  hatreds  evoke  many  curious  problems.  There  are 
people  to  whom  it  is  less  disturbing  to  think  that  in  the 
remote  past  their  ancestors  might  have  appeared  more 
simian  than  it  is  to  think  that  under  present  conditions' 
they  are  members  of  the  same  species  as  the  Negro,  the 
Chinaman,  the  Digger  Indian,  or  the  cannibal  of  the 
south  seas.  Yet  this  is  a  point  which  admits  not  of  dis- 
pute, for  by  the  law  of  Fertility,  which  physiologists  now 
agree  in  accepting  as  a  leading  test  of  varietal  and 
specific  difference,  all  races  of  Man  are,  and  have  been 
for  ages,  permanently  fertile,  while  such  a  condition  does 
not  exist,  and,  indeed,  cannot  be  forced  to  exist,  between 
Man  and  any  other  species. 

This  possibility  of  miscegenation  is  extremely  obvious 
in  North  America,  so  much  so  that  it  would  scarcely 
need  to  be  pointed  out  save  to  show  that  if  it  were  not 
so  Ethnology  would  have  no  problems  to  consider  at 
all;  for  on  the  one  hand  and  on  the  other  would  be  races 
complete,  their  respective  characteristics  continuing  with- 
out any  direct  change — and  there  would  be  an  end  of  it. 
But  Ethnology  faces  one  of  the  most  complex  of  all  prob- 
lems, for  the  reason  that  the  entire  readiness  of  one  race 
to  absorb  and  of  another  to  be  absorbed,  coupled  with 
the  unwavering  persistence  of  certain  peculiarities  (not 
always  the  most  obvious),  obliterates  all  hard  and  fast 
lines  of  division  and  reveals  the  imperceptible  grada- 
tions by  which  one  race  shades  into  another. 

32 


THE  UNITY  AND  VARIETY  OF  MAN         33 

If  it  were  feasible  to  produce  a  map  of  the  populated 
world  wherein  the  particular  color  scale  of  each  district, 
could  be  painted  in,  all  following  a  definite  average,  the 
colors  ranging  from  the  flesh  color  of  a  northern  Scan- 
dinavian to  the  almost  jet  black  of  certain  Negro  tribes, 
such  a  map  would  appear  greatly  mottled  owing  to  the 
manner  in  which  certain  settlements  of  variant  races  have 
strayed  in.  Viewed  from  a  fair  perspective,  the  shading 
from  fair  to  dark  would  reveal  blending  everywhere  and 
harsh  lines  of  division  nowhere. 

This  same  difficulty  becomes  apparent  also  in  the  re- 
mains of  Prehistoric  Man,  altho  this  point  is  often 
curiously  ignored.  Thus,  it  does  by  no  means  follow 
that  the  discovery  of  a  certain  paleolithic  skull  in  a  cer- 
tain locality  presupposes  the  existence  of  a  race  of  men 
markedly  similar.  This  objection  ceases  in  the  later  neo- 
lithic times,  when  an  abundance  of  remains  yields  defi- 
nite averages.  Certain  discoveries,  however,  point  to  an 
earlier  physical  form  of  Man  than  any  which  are  now 
known,  and  these  have  formed  the  basis  for  much  anthro- 
pological argument.  The  men  of  Neanderthal,  of  Spy, 
of  Laugerie-Basse,  and  the  latest  of  all — the  Pithecan- 
thropus Erectus,  or  "the  fossil  ape-man  of  Java" — have 
formed  the  basis,  respectively,  for  an  immense  amount 
of  description,  of  comparison,  and  of  surmise. 

The  discoveries  of  the  actual  osseous  remains  of  primi- 
tive man  are  of  vast  importance,  but  they  are  very  few. 
Thus,  for  example,  the  Pithecanthropus  Erectus,  around 
which  so  much  comment  and  criticism  has  gathered,  is 
deduced  merely  from  the  roof  of  the  skull,  and  one  tooth 
and  one  thigh  bone  which  may  or  may  not  have  been 
part  of  the  same  creature.  A.  H.  Keane,  in  his  'Eth- 
nology/ has  classified  the  remains  worthy  of  credence 
as  follows: 

"Triml  (Pithecanthropus  Erectus),  found  on  the  left 
bank  of  the  river  Bengawan,  Java.  Roof  of  skull,  an 
upper  molar  and  a  femur,  found  (1894)  by  Dr.  Eugene 


34 


ANTHROPOLOGY 


Dubois  in  pleistocene  (?)  bed  12  to  15  meters  below  the 
surface.  Showing  characters  intermediate  between  go- 
rilla and  Neanderthal,  but  distinctly  human,  low  depressed 
cranial  arch;  'the  lowest  human  cranium  yet  described, 
very  nearly  as  much  below  the  Neanderthal  as  this  is 
below  the  normal  European';  femur  quite  human;  tooth 
very  large  but  more  human  than  simian. 


Fig.  10 — REMAINS  OF  NEANDERTHAL  MAN 


"Neanderthal,  a  brain-cap,  two  femora,  two  humeri, 
and  some  other  fragments;  remarkable  for  its  flat,  re- 
treating curve;  the  most  apelike  skull,  next  to  the  Pithe- 
canthropus Erectus. 

"La  Naulette,  Belgium,  an  imperfect  lower  jaw;  simian 


THE  UNITY  AND  VARIETY  OF  MAN         35 

characters  very  pronounced  in  the  extreme  prognathism 
and  alveolar  process. 

"La  Denise,  France,  two  depressed  and  retreating  fron- 
tal bones,  glabella  of  one  very  prominent,  recalling  the 
Neanderthal;  that  of  the  other  also  prominent,  and  sepa- 
rated from  the  retreating  frontal  bone  by  a  deep  depres- 
sion. 

"Brux,  Bohemia,  a  brain-cap  and  other  bones;  frontal 
region  and  flat,  elongated  parietals  like  those  of  Nean- 
derthal and  Eguisheim,  but  superciliary  bosses  larger  than 
the  latter. 

"Spy,  Belgium,  two  nearly  perfect  skeletons  (man  and 
woman)  ;  enormous  superciliary  ridges  and  glabella,  re- 


Fig,  ii — SKULL  OF  THE  MAN  OF  SPY 


treating  frontal  region ;  extremely  thick  cranial  wall,  mas- 
sive mandibular  ramus  with  rudimentary  chin.  Large 
posterior  molars ;  divergent  curvature  of  bones  of  fore- 
arm; tibia  shorter  than  in  any  known  race,  and  stouter 
than  in  most ;  tibia  and  femur  so  articulated  that  to  main- 
tain equilibrium  head  and  body  must  have  been  thrown 
forward  as  in  the  largest  apes. 

"Galley  Hill,  England,  nearly  perfect  skeleton,  skull 
extremely  long,  narrow,  and  much  depressed;  glabella 
and  brow  ridged,  prominent;  forehead  somewhat  reced- 
ing ;  height  about  5  ft.  i  in. ;  altogether,  most  nearly  re- 
lated to  the  Neanderthal,  Spy,  and  Naulette  types. 


36  ANTHROPOLOGY 

"Podbaba,  Poland,  fragment  of  skull;  approaches  the 
Neanderthal  type. 

"Predmost,  Bohemia,  fragments  of  skeletons  of  six  per- 
sons, similar  to  Neanderthal  type;  that  of  man  wonder- 
fully complete,  and  of  gigantic  proportions. 

"Marcilly  sur  Eure,  Belgium  (?),  part  of  skull,  also 
of  Neanderthal  type. 

"Arcy-sur-Eure,  Belgium  (?),  lower  jaw,  somewhat 
modified  Naulette  type. 

"Olmo,  Italy,  skull;  above  that  of  Neanderthal.  A 
doubtful  find. 

"Eguisheim,  Germany,  part  of  skull,  prominent  super- 


Fig.  12 — COMPARISON  OF  CRANIA 

a.  Average  European  skull;  b,  Spy;  c,  Neanderthal;  d,  pithecan- 
thropus ;  e,  gorilla. 

ciliary  ridges,  frontal  region  broad  but  retreating,  sutures 
simple  and  nearly  effaced. 

"Laugerie-Basse,  France,  one  skeleton  (male),  two 
skulls  (female)  ;  thick  parietals;  cranial  capacity  above 
the  modern  average  in  the  male  and  in  one  female  skull, 
but  in  the  other  female  very  low. 

"The  foregoing,"  says  Keane  (writing  before  the  recent 
discovery  of  Chapelle-aux-Saints),  "belong  to  various 
paleolithic  epochs,  and  while  all,  without  exception,  are 


THE  UNITY  AND  VARIETY  OF  MAN         37 

dolichocephalic  (index  ranging  from  about  70  to  75),  the 
distinctly  low  characters  show  progressive  modifica- 
tions in  the  direction  of  the  higher  neolithic  and  modern 
types."  Keane  goes  on  to  point  out  that  both  in  France* 
and  England,  following  a  large  number  of  finds,  the  ear- 
liest men  "appear  to  have  been  first  of  long,  then  of  me- 
dium, and  lastly,  in  some  places,  of  exclusively  round- 
headed  type  (of  skull)." 

If,  then,  the  early  times  reveal  the  possibilities  of  in- 
definite crossings  and  intermarrying  among  variant  races, 
it  is  next  in  order  to  point  out  that  such  intermarrying 
is  permanent,  and  that,  far  from  producing  a  weak  breed, 
it  possesses  a  definite  strength  of  its  own.  The  statement 
made  by  Dr.  Robert  Dunn,  in  his  'Unity  of  the  Human 
Species/  that  "half-castes  very  generally  combine  the  best 
attributes  of  the  two  races  from  whence  they  originate," 
might  be  somewhat  qualified. 

In  the  far  north  the  Dano-Eskimo  half-breeds  of  Green- 
land are  becoming  the  dominant  race;  in  Canada  the  fa- 
mous French  Canadian-Algonkian  voyageurs  were  among 
the  hardiest  races  ever  seen;  in  the  United  States  the 
high  birth-rate  of  mixed  negro  and  white  blood  is  well 
known;  and  in  Brazil  the  cross  between  the  first  Portu- 
guese immigrant  and  the  aborigines,  the  so-called  "Pau- 
lista"  half-breeds,  are  "the  most  vigorous  and  enterprising 
section  of  the  community." 

In  Africa,  the  'bastaards/  or  Hottentot-Dutch  cross — 
could  more  dissimilar  races  be  selected ! — form  flourish- 
ing communities  in  Griqualand,  and  are  known  as  Gri- 
quas;  the  Negro-Hottentots  have  crossed  to  form  the 
Gonaquas;  the  Gallas  are  Negro  and  Hamite;  the  Abys- 
sinians  are  Negro,  Hamite  and  Semite. 

In  Asia,  the  Baltis  are  part  Mongol  and  part  Aryan, 
the  Dravidian  aborigines  mix  with  the  Aryans  to  their 
profit,  and  the  Franco-Annamese  in  Cochin  China,  known 
as  the  Minh-huongs,  are  said  by  M.  Morice  to  be  increas- 
ing in  number,  to  be  well  adapted  to  climate,  and  to  pos- 


38  ANTHROPOLOGY 

sess  powers  finer  than  their  former  savage  race.  Cer- 
tain of  the  Oceanic  Islands,  such  as  the  Philippines,  have 
all  the  four  varieties  of  the  human  species  intermingled. 

The  famous  Pitcairn  Island  mutineers  are  a  historic 
case.  In  1789  the  mutineers  from  an  English  ship,  the 
'Bounty/  nine  in  number,  all  English,  were  marooned  on 
Pitcairn  Island,  with  six  male  and  fifteen  female  Tahi- 
tians.  Strife  was  constant  over  the  possession  of  the 
women,  and  when  the  island  was  next  visited,  four  years 
later,  five  of  the  English  sailors,  all  the  Tahitian  men, 
and  five  of  the  Tahitian  women  had  been  killed.  The 
four  remaining  Englishmen  had  made  a  partition  among 
themselves  of  the  ten  Tahitian  women,  realizing  that 
life  would  be  impossible  if  every  man's  hand  was  against 
his  neighbor.  In  1825  the  colony  had  increased  to  66 
persons,  and  in  1891  to  120.  The  islanders  are  very  dark 
in  .complexion,  but  possess  Caucasian  features;  their  in- 
telligence is  of  a  fine  order,  and  their  physical  resist- 
ance is  high. 

"It  may  be  concluded  on  inductive  evidence,"  comments 
Keane,  "that  all  the  Hominidae  (Man)  are,  and  always 
have  been,  permanently  fertile  with  each  other.  Eugene- 
sis  (indefinitely  fertile  miscegenation)  is  the  norm,  and 
to  it  must,  in  fact,  be  attributed  the  endless  varieties  of 
mankind,  which  may  be  said  to  have  almost  everywhere 
supplanted  the  few  original  fundamental  stocks." 

The  first  serious  attempt  at  a  systematic  grouping  of 
the  races  of  Man  was  made  by  F.  Bernier  (1625-1688), 
who  distinguished  four  types:  the  European  white,  the 
African  black,  the  Asiatic  yellow,  and  the  northern  Lapp ! 
Linnaeus  (1738-1783)  followed  with  his  'Homo  monstruo- 
sus,'  'Homo  ferus/  and  'Homo  sapiens/  The  'Homo  ferus/ 
being  dumb,  and  covered  with  hair,  answers  somewhat 
to  Haeckel's  'Homo  alalus/  while  the  group  'Homo  sa- 
piens* comprises  four  varieties:  the  fair-haired,  blue-eyed 
and  light-skinned  European;  the  yellowish,  brown-eyed, 
black-haired  Asiatic;  the  black-haired,  beardless,  tawny 


THE  UNITY  AND  VARIETY  OF  MAN         39 

American;  the  black,  woolly-haired,  flat-nosed  African. 
Blumenbach  (1752-1840)  followed  with  his  five  varieties 
bearing  a  nomenclature  that  still  largely  persists:  'Cau- 
casic/  'Mongolia,'  'Ethiopia,'  'American'  and  'Malay/  But 
Blumenbach  later  (1795)  fell  back  on  Linne's  four  varie- 
ties, which,  however,  he  distributed  somewhat  differently, 
assigning  to  the  Caucasic  most  of  Europe,  Cis-gangetic 
Asia  and  the  region  stretching  northward  from  the  Amur 
basin;  to  the  Mongolic  Trans-gangetic  Asia  north  to  the 
Amur  "with  the  islanders  and  great  part  of  the  Austral 
lands";  to  the  Ethiopia,  Africa;  and  to  the  American, 
all  the  New  World,  except  the  northern  coastlands — that 
is,  the  Eskimo  domain — which  he  includes  in  the  Mongolic 
division." 

Then  ensued  a  period  of  orthodox  reaction  against  the 
Lamarckian  ideas  headed  by  Cuvier  (1773-1838),  who 
held  by  fixity  of  species,  but  inconsistently  admitted  three 
races,  the  Caucasic,  Mongolic  and  African,  supposed  to 
answer  to  the  biblical  Japhetic,  Semitic  and  Hamitic  fam- 
ilies. In  1801,  Virey  (1775-1840)  reduced  Cuvier's  three 
divisions  to  two  distinct  'species/  white  and  black,  each 
with  three  main  'races'  or  subspecies,  which  again  com- 
prised a  number  of  secondary  groups.  But  this  could 
not  satisfy  thoro-going  polygenists,  *such  as  Desmoulins, 
who  started  eleven  human  species  in  1825,  and  the  next 
year  raised  them  to  sixteen ;  Bory  de  Saint-Vincent,  who 
in  1827  discovered  fifteen  species,  including  such  nebulous 
groups  as  "Scythians,"  "Neptunians,"  "Columbians" ;  last- 
ly, the  American  school,  which,  in  the  hands  of  Morton, 
Gliddon,  Knox,  Agassiz,  and  others,  brought  about  an 
inevitable  reaction  by  threatening  to  increase  the  num- 
ber of  species  indefinitely.  Other  groupings,  which  were 
marked  by  greater  sobriety,  and  which  still  possess  some 
historic  interest,  were  those  of  Hamilton  Smith  (Caucasic, 
Mongolic,  Tropical)  ;  Latham  (Japhetic,  Mongoloid,  At- 
lantides)  ;  Karl  G.  Carus  (four  divisions  somewhat  fan- 
tastically named  'Nachtmenschen,'  "Night-men,"  the  Ne- 


40  ANTHROPOLOGY 

gro;  Tagmenschen/  "Day-men/*  the  Caucasian;  'ostliche 
Dammerungsmenschen/  "Men  of  the  eastern  twilight/* 
Mongolo-Malayo-Hindu  peoples ;  and  'westliche  Dammer- 
ungsmenschen/ "Men  of  the  western  twilight/*  the  Ameri- 
can aborigines)  ;  and  Peschel  (Australian  with  Tas- 
manian,  Papuan,  Mongoloid  with  Malayo-Polynesian  and 
American,  Dravidian,  Hottentot  with  Bushman,  Negro, 
Mediterranean — i.e.,  Blumenbach's  Caucasian). 

A  fresh  element  of  confusion,  which  still  clings  to 
ethnological  studies,  arose  out  of  Frederick  Schlegel's 
little  treatise  on  the  "Language  and  Wisdom  of  the  Hin- 
dus" (1808),  which  was  later  declared  by  Max  Muller 
to  have  revealed  a  new  world,  and  to  have  shown  what 
unexpected  services  Anthropology  might  derive  from  the 
science  of  language.  The  extreme  views  of  the  ensuing 
philologists  were  countered  by  Nott,  Gliddon  and  Knox, 
who  suggested  an  unlimited  number  of  human  species 
and  varieties. 

Meanwhile,  the  way  had  been  prepared  for  a  more  ra- 
tional treatment  of  racial  diversity  by  Dr.  James  Cowles 
Prichard,  who,  not  without  reason,  is  by  many  regarded 
as  the  true  founder  of  ethnology  as  a  distinct  branch  of 
general  anthropology.  At  least,  suggests  Keane,  he  may 
share  this  honor  with  Buffon,  who,  so  early  as  1749,  had 
undertaken  THistoire  Complete  de  1'Homme/  as  a  part 
of  his  great  work  on  the  Animal  Kingdom  (1749-1788). 

His  'Crania  of  the  Laplanders  and  Finlanders/  contin- 
ued by  the  more  solid  work  of  the  elder  Retzius  in  the 
same  field,  gave  a  fresh  impulse  to  craniological  studies 
which  had  already  been  cultivated  by  Morton,  and  on 
which  Geoflroy  Saint-Hilaire  based  his  four  fundamen- 
tal types :  orthognathous,  eurygnathous,  prognathous  and 
euryprognathous  (1858).  Thus  were  laid  the  founda- 
tions of  the  comparative  study  of  the  Hominidae  based 
on  their  physical  characters,  a  line  of  inquiry  which,  in 
the  hands  of  Broca,  de  Quatrefages  and  Hamy  ('Crania 
Ethnica),  Topinard,  Virchow,  Kollmann,  Mantegazza, 


THE  UNITY  AND  VARIETY  OF  MAN         41 

Pruner  Bey,  Barnard  Davis,  Beddoe,  Huxley,  Thurnam, 
Turner,  Rolleston,  Flower,  Macalister,  Garson,  Cope,  and 
others,  has  led  to  fruitful  results. 

Among  these  latter  it  is  notable  that  a  great  emphasis 
is  laid  upon  the  hair.  Thus  Ernst  Haeckel  made  a  di- 
vision into  two,  the  Ulotriches,  or  Woolly-Haired,  and 
the  Lissotriches,  or  Lank-Haired,  the  former  of  which 
he  divided  into  Tufted  and  Fleecy  and  the  second  into 
Straight  and  Curly.  De  Quatrefages  remained  faithful 
to  color,  and  divided  the  Human  race  into  White,  or 
Caucasic ;  Yellow,  or  Mongolic ;  Negro,  or  Ethiopic.  Hux- 
ley followed  the  division  of  Bory  St.  Vincent,  of  Ulo- 
trichi,  Woolly-haired,  and  Leotrichi,  Smooth-haired,  and 
divided  the  latter  into  four  divisions  on  the  ground  of 
color.  Broca  made  a  tripartite  division  on  the  basis  of 
hair,  Straight-haired,  Curly-haired  and  Woolly-haired,  di- 
vided that  again  by  the  shape  of  the  skull,  and  then  sub- 
divided on  the  basis  of  color.  Miiller  followed  the  line 
of  Huxley.  J.  Deniker  devised  a  complex  scheme  on 
the  basis  that  every  ethnical  group  results  from  a  fusion 
of  races,  and  therefore  all  such  groups  must  possess  types, 
which  cross  and  commingle  in  a  bewildering  fashion.  It 
also  is  notable  in  the  hair  relations  between  man  and  ape 
as  shown  in  Fig.  3  and  Fig.  13.  In  the  latter  the  embryo 
and  the  'dog  man'  are  both  more  hirsute  than  the  gorilla. 

From  a  general  survey  of  the  various  schemes  it  ap- 
pears that  special,  if  not  paramount,  importance  is  given 
by  these  systematists  to  the  three  elements  of  complexion, 
character  of  the  hair,  and  shape  of  the  skull.  Precedence 
may  be  claimed  for  color,  at  least  as  the  element  which 
occurs  first  to  the  observer,  and  on  which,  probably  for 
that  reason,  the  first  groupings  were  determined.  It  ap- 
pears that  the  pigment,  or  coloring  matter,  situated  chiefly 
in  the  'rete  mucosum/  or  lower  layer  of  the  cuticle,  which 
was  formerly  supposed  to  be  peculiar  to  the  Negro,  is  real- 
ly common  to  all  races,  only  more  abundant,  and  of  darker 
hue,  in  the  Negro,  the  Papuan,  Australian  and  Oceanic 


42  ANTHROPOLOGY 

Negrito.  Nor  is  there  any  necessary  correlation  between 
this  darker  hue  and  other  Negro  characters,  as  appears 
from  its  presence  in  many  Somal,  Galla  and  other  Ha- 
mitic  and  even  Semitic  groups  of  quite  regular  features. 


Fig.  13 — FACIAL  HAIR  OF  MAN  AND  APE 


Upper  pair,  front  and  side  views  of  gorilla — (Brehm). 
Lower  pair,  human  embryo  five  months  old  (Ecker)  ;  and  Andrian 
Jeftichjeis,  "the  Russian  dog  man." 

It  is  important  to  note  that  the  palms  and  soles  of  the 
Negro  are  never  black,  but  always  yellowish,  that  the 
dark  pigment  is  wanting  in  the  Negro  fetus,  and  that 
Negro  children  are  born,  according  to  Waitz,  "of  a  light 


THE  UNITY  AND  VARIETY  OF  MAN          43 

gray  color. "  Hence  it  might  be  inferred  that  the  dark 
color,  with  which  a  thicker  skin  is  correlated,  is  a  later 
development,  an  adaptation  of  the  organism  to  a  hot, 
rnoist  malarious  climate,  in  which  the  Negro  thrives  and 
the  white  man  perishes. 

"Thus  color,  taken  alone,"  says  A.  H.  Keane  in  his 
'Ethnology/  "cannot  be  regarded  as  an  entirely  trustworthy 
test  of  race,  the  less  so  that  even  blackness  is  not  an  ex- 
clusively Negro  character,  but  common  also  to  many  east- 
ern Hamites  (Agaos,  Bejas,  Somals,  Gallas),  and  to  nu- 
merous aborigines  of  India.  Nevertheless,  it  is  far  too 
important  a  factor  to  be  overlooked,  and  taken  in  com- 
bination with  other  characters  will  lead  to  satisfactory 
results.  Although  the  transitions,  as  in  other  physical 
traits,  are  complete,  there  appear  to  be  about  six  primary 
colors  to  which  all  the  human  groups  may  be  referred,  as 
under : 

"Black. — African  and  Oceanic  Negroes ;  Australians ; 
Tasmanians;  some  aborigines  of  India  and  America;  East- 
ern Harnites. 

"Yellow. — Mongols;  Indo-Chinese;  Japanese;  Tibetans; 
some  South  Americans;  Bushmen;  Hottentots. 

"Brown. — Polynesians;  Hindus;  Plateau  Indians  of 
America;  many  Negritoes;  Fulahs. 

"Coppery  red. — Prairie  Indians    ("Redskins"). 

"Florid  white. — Northern  Europeans;  Lapps;  Finns; 
Xanthochroid  Caucasians  generally. 

"Pale  white. — Southern  Europeans ;  Iranians ;  many 
Semites  and  Western  Hamites;  Melanochroid  Caucasians 
generally." 

The  hair,  if  not  regarded  as  of  more  importance  than 
the  complexion,  has  steadily  risen  in  favor  with  syste- 
matists,  especially  since  a  paper  by  Pruner  Bey  "On  the 
human  hair  as  a  race  character,  examined  by  the  aid  of 
the  microscope,"  before  the  Paris  Anthropological  So- 
ciety, 1863.  Since  then  this  element,  previously  little  at- 
tended to,  has  been  made  the  base,  or  leading  character, 


44  ANTHROPOLOGY 

in  the  groupings  of  some  of  the  most  eminent  recent  eth- 
nologists. The  reason  is  that  both  color  and  texture  of 
the  hair  are  found  to  be  extremely  constant  characters, 
resisting  time  and  climate  with  wonderful  tenacity,  and 
presenting  remarkable  uniformity  throughout  large  sec- 
tions of  the  human  family.  Thus  all  the  American  abo- 
rigines, from  Fuegia  to  Alaska,  as  well  as  most  of  the 
Mongoloid,  Malay,  and  Eastern  Polynesian  peoples,  are 
invariably  distinguished  by  the  same  black,  lank,  some- 
what coarse  and  lusterless  hair,  round,  or  nearly  round, 
in  transverse  section.  No  other  single  physical  trait  can 
be  mentioned  which  is  to  the  same  extent  characteristic  of 
several  hundred  millions  of  human  beings  distributed  over 
every  climatic  zone  from  the  Arctic  to  the  Antarctic 
waters,  and  ranging  from  sea-level  (Fuegia,  Mackenzie 
estuary)  to  altitudes  of  12,000  and  even  16,000  feet  (Bo- 
livian and  Tibetan  plateaux).  So,  also,  short,  black,  woolly, 
or  at  least  crisp,  or  frizzly  hair,  elliptical  and  even  some- 
what flat  in  transverse  section,  is  a  constant  feature  of 
the  Negroes,  Hottentots,  Bushmen,  Negritoes,  Papuans, 
Melanesians,  Tasmanians,  in  fact  of  all  the  distinctly  dark 
Negroid  populations,  say,  of  150  million  members  of  the 
human  family.  Lastly,  hair  of  intermediate  types,  black, 
brown,  flaxen,  red,  smooth,  wavy  or  curly,  and  generally 
oval  in  transverse  section,  prevails  among  both  sections  of 
the  Caucasic  division,  which  may  now  be  estimated  at  700 
or  800  millions. 

From  Pruner's  microscopic  studies  it  appears  that,  apart 
from  its  color,  the  structure  of  the  hair  is  threefold:1 
I.  Short,  crisp  or  fleecy,  usually  called  "woolly,"  elliptical 
or  kidney-shaped  in  section,  with  mean  diameters  20 :  12 
in  hundreds  of  millimeters ;  no  perceptible  medullary  tube, 
and  often  relatively  flat,  especially  in  Papuans ;  color  al- 
most invariably  jet  black;  characteristic  of  all  black  races 
except  the  Australians,  and  aborigines  of  India.  2.  Long, 
lank,  of  the  horse-mane  type,  cylindrical,  hence  round,  or 
nearly  so,  in  section,  with  diameters  either  about  24,  or, 


THE  UNITY  AND  VARIETY  OF  MAN         45 

if  elongated,  27:23;  distinct  tube,  filled  with  medullary 
substance;  color  mainly  black  or  blue-black;  characteristic 
of  all  American  and  Mongoloid  peoples.  3.  Intermediate, 
wavy,  curly  or  smooth;  oval  in  section,  with  long  and 
short  diameters  23:17  or  20:15;  distinct  tube,  but  empty 
or  diaphanous;  all  colors  from  black  through  every  shade 
of  brown  to  flaxen,  red  and  towy;  characteristic  of  most 
Caucasic  peoples,  but  in  the  eastern  Hamites  and  some 
others  developing  long,  ringletty  curls. 

The  third  basis  customarily  used  in  Modern  Ethnology 
is  the  relative  size  of  the  skull.  The  importance  of  this 
measurement  is  because  the  relation  of  mental  power  to 
cranial  capacity  is  close.  "Casts  of  the  interior  of  the 
skull/'  says  Romanes,  "show  that  all  the  earlier  mammals 
had  small  brains,  with  comparatively  smooth  or  uncon- 
voluted  surfaces;  and  that,  as  time  went  on,  the  mam- 
malian brain  gradually  advanced  in  size  and  complexity. 
Indeed,  so  small  were  the  cerebral  hemispheres  of  the 
primitive  mammals  that  they  did  not  overlap  the  cere- 
bellum, while  their  smoothness  must  have  been  such  as  in 
this  respect  to  have  resembled  the  brain  of  a  bird  or 
reptile.  This,  of  course,  is  just  as  it  ought  to  be,  if  the 
brain,  which  the  skull  has  to  accommodate,  has  been  grad- 
ually evolved  into  larger  and  larger  proportions  in  re- 
spect of  its  cerebral  hemispheres,  or  the  upper  masses 
of  it,  which  constitute  the  seat  of  intelligence." 

The  skull  measurement  is  taken  from  between  the  eye- 
brows to  the  extreme  back  of  the  skull,  and  the  trans- 
verse diameter  from  side  to  side.  The  distance  from 
between  eyebrows  (glabella)  to  extreme  point  at  back 
(occiput)  being  taken  at  100,  the  width  of  the  head  is 
then  compared  with  that,  and  the  proportion  stated  in 
percentage  terms.  The  extremes  appear  to  lie  between 
61.9,  a  Fijian,  and  98.21,  a  Mongolian,  and  from  70  to  90 
will  include  all  save  a  few  races.  Where  the  width  is 
75>  or  under,  it  is  termed  Dolichocephalic  or  Long- 
Headed;  from  75.01  to  77.77,  Subdolichocephalic,  or  ap- 


46 


ANTHROPOLOGY 


proximating  Long-Headedness ;  from  77.78  to  80,  Mesa- 
ticephalic,  or  Medium -Headed;  from  80.01  to  83.33,  aP" 
proximating  Broad-Headedness ;  from  83.34  upward, 
Broad-Headedness. 

Thus,  among  the  Long-Headed  will  come  the  Kai-Colos 
of  Fiji,  65;  the  Eskimo,  71.77;  the  Neanderthal  man,  72; 
the  Hottentot  and  the  Bushman,  72.42;  West  African 
negro,  73.40 ;  the  Arab,  74.06.  Among  those  who  approxi- 


Fig.   14 — ORTHOGNATHOUS  SKULL  OF  KALMUK 

mate  Long-Headedness  come  the  Neolithic  men,  75.01 ; 
the  ancient  Egyptians,  75.78;  the  Anglo-Saxons,  76.10; 
and  the  Chinese,  77.60. 

Among  the  Medium-headed  are  the  Ancient  Gauls, 
78.09;  Mexicans,  78.12;  the  Dutch,  78.89;  North  Ameri- 
cans, 79.25 ;  Hawaiians,  80.  The  next  division  leading  to 
the  Broad-Heads  contains  the  Mongols,  81.40;  Turks, 
81.49;  Italians,  81.80;  Finns,  82;  and  South  Germans,  83. 
Then  in  the  Broad-headed  races  are  found  the  Indo-Chi- 
nese, 83.51;  Bavarians,  84.87;  Lapps,  85.07;  Burmese,  86; 
Armenians,  86.5 ;  Peruvians,  93. 


THE  UNITY  AND  VARIETY  OF  MAN         47 

The  famous  "facial  angle,"  or  the  means  of  determin- 
ing gnathism,  is  of  great  importance.  Refraining  from 
hyper-detailed  statements  of  the  modes  of  measurement, 
it  may  be  said  that  gnathism  is  the  greater  or  less  pro- 
jection of  the  upper  jaw,  which  itself  depends  upon  the 
angle  made  by  the  whole  face  with  the  brain-cap.  Gen- 
erally speaking,  facially  it  is  the  projection  of  the  jaw 
beyond  a  perpendicular  line  dropped  from  the  forehead. 
The  divisions  between  the  races  are  clear  and  sharp.  Thus 


Fig.   15 — PROGNATHOUS  SKULL  OF  NEGRO 

the  white  races  (pethognathous)  range  from  89°  to  81.30°, 
the  yellow  races  (mesognathous)  from  82°  to  76.58°,  and 
the  black  races  (prognathous)  from  69°  to  59.5°. 

Stature  is  also  easily  recognised,  but  it  is  more  variant 
and  the  range  between  individuals  of  a  race  is  great.  De- 
spite this,  however,  certain  distinct  classifications  do  ap- 
pear and  the  Patagonian  Giants  and  the  African  Pigmies 
occupy  opposing  ends  of  the  scale.  Excluding  the  abnor- 
mal dwarfish  and  gigantic  specimens  of  the  showmen,  the 
height  ranges  from  between  4  feet  7  inches  and  6  feet  2 


48  ANTHROPOLOGY 

inches  with  a  mean  of  5^  feet;  this  for  the  male  adult, 
from  which  for  the  female  must  be  deducted  about  8  per 
cent,  in  the  tall  and  5  per  cent,  in  the  short  races.  Broca 
and  Topinard  show  that  all  the  Negritos  are  dwarfish, 
the  true  Negroes  tall,  the  Mongols  rather  below  the  aver- 
age, the  Americans  extremely  variable. 

The  nose  also  is  a  well-known  characteristic,  as  the  He- 
brew illustrates.  It  may  be  normally  thin,  prominent, 
long,  straight  or  else  convex  (arched  or  hooked)  in  the 
higher  races,  in  the  lower  short,  broad,  more  or  less  con- 
cave and  even  flat.  A  careful  study  of  this  organ  shows 
almost  better  than  any  other  the  coordination  of  parts  in 
the  facial  features  generally.  Thus  the  small  flat  concave 
is  usually  correlated  with  high  cheek-bones  and  narrow 
oblique  eyes  (Mongol)  ;  the  short  with  wide  nostrils  and 
depressed  root,  with  everted  lips  and  bombed  frontal  bone 
(Negro)  ;  the  short  with  blunt  rounded  base  and  depressed 
root,  with  heavy  superciliary  ridges  and  long  upper  lip 
(primitive  Australian  and  Tasmanian)  ;  the  large,  straight 
or  arched,  with  regular  oval  features  (Semite  and  Euro- 
pean). 

There  is,  however,  a  distinct  line  between  the  study  of 
Mankind  in  races  and  in  peoples,  just  as  there  is  a  distinct 
difference  between  the  study  of  Man  as  the  individual  and 
as  the  race.  The  study  of  the  individual  is  what  has  been 
called  Physical  Anthropology,  the  study  of  the  race  has 
been  called  Ethnology  and  the  study  of  a  people  might  well 
be  called  Ethnography.  Yet  Man  is  always  a  member  of  a 
community  and  can  never  be  considered  without  reference 
to  that  relation,  and  it  would  be  a  false  presentation  to 
show  him  as  an  individual  and  as  a  race  without  also 
depicting  his  position  as  a  member  of  an  ethnographic 
group. 


CHAPTER  IV 

THE  RACIAL  DIVISIONS  OF  MAN 

THE  consideration  of  the  physical  characteristics  and 
measurements  of  Man,  it  will  be  noted,  have  brought  to 
light  some  very  striking  coincidences  with  regard  to  the 
racial  divisions  made  by  anthropologists.  Thus,  for  ex- 
ample, in  cranial  capacity,  in  gnathism,  in  physiognomy, 
in  hair  and  in  many  less  obtrusive  ways  it  is  seen  that  there 
is  a  distinct  line  of  difference  between  the  white  race  and 
the  black.  A  man  whose  color  is  black,  whose  hair  is  blue- 
black  and  flat  in  transverse  section,  whose  jaws  are  prog- 
nathous, whose  lips  are  intumescent,  whose  nose  is  broad, 
flat  and  with  diverging  nostrils,  and  whose  teeth  are  large, 
cannot  be  regarded  as  similar  to  a  man  whose  color  is 
white,  whose  hair  is  flaxen  with  elliptical  section,  whose 
jaws  are  orthognathous,  whose  nose  is  arched  or  straight 
with  nostrils  not  diverging,  and  whose  teeth  are  small. 
When,  in  addition  to  this,  the  speech,  the  customs,  the 
religion  and  the  temperant  are  diametrically  opposite,  it  is 
clear  that  these  concordances  definitely  separate  one  race 
from  another. 

When  the  question  is  raised,  however,  as  to  how  many 
races  there  are  in  the  human  species,  it  must  be  admitted 
that  a  definitive  answer  is  hard  to  give.  There  are  cer- 
tainly three  -distinct  types  and  probably  a  fourth,  but  it 
seems  equally  certain  that  one  of  these  first  three  is  a 
thoroly  mixed  race,  being  based  largely  on  a  type  that  has 
almost  disappeared.  The  reference  is  to  the  Caucasian 

49 


50  ANTHROPOLOGY 

race,  which  carries  on  many  of  the  characteristics  of  an 
Archaean  white  race,  now  extinct. 

There  are  two  races,  however,  whose  case  is  simple  and 
clear,  the  Yellow  race  or  the  Mongoloid  and  the  Black 
race  or  the  Negroid.  There  has  not  been  any  scheme  pro- 
posed in  any  age  which  put  these  two  races  together  in  a 
classification  that  has  gained  even  momentary  support 
among  scientific  men.  Whether  color,  skull,  hair,  lan- 
guage or  customs  be  brought  to  bear,  these  two  races  re- 
main apart.  It  is  certain,  then,  that  of  the  human  species 
there  are  at  least  two  divisions,  yellow  and  black,  or  Mon- 
goloid and  Negroid. 

The  Caucasian,  or  the  White  Race,  brings  up  more  diffi- 
cult questions.  Just  as  the  Mongoloid  and  Negroid  are 
diverse,  so  is  the  blue-eyed,  flaxen,  wavy-haired,  ruddy 
and  white  complexioned  Celt  different  in  almost  every  par- 
ticular. But  the  White  Race,  as  it  is  often  called,  is  taken 
to  include  a  wide  diversity  of  types,  many  of  whom  are 
not  white  at  all.  Thus,  for  example,  Keane  points  out 
that  the  Black  Berbers  are  Caucasic,  and  he  goes  so  far 
as  to  class  the  Maoris  of  New  Zealand,  the  Dyaks  of  Bor- 
neo and  the  Hawaiian  Islanders  under  a  branch  of  the 
White  Race.  With  this,  tho,  present  writers  cannot  agree. 

There  are  certain  points,  however,  even  in  this  compli- 
cated matter  that  seem  fairly  clear.  One  is,  that  the  fur- 
ther away  from  the  center  of  the  continent  of  Europe  and 
Asia  the  observer  goes,  the  more  clearly  do  the  evidences 
of  a  white  race  appear.  Thus  the  nearest  possible  physical 
kinship  is  to  be  seen  between  a  Celt  and  an  Aino  of  Japan. 
Whatever  doubt  there  may  be  about  certain  other  savage 
races,  there  is  little  doubt  with  regard  to  these. 

As  A.  H.  Savage  Landor  has  pointed  out  in  his  'Alone 
with  the  Hairy  Ainu/  they  possess  all  the  physical  charac- 
teristics of  the  Caucasian.  Living  at  the  extreme  eastern 
point  of  the  continent,  the  Ainos  are  fair  in  complexion, 
rarely  being  as  dark  even  as  a  southern  Frenchman ;  the 
eyes  have  but  little  coloring  pigment,  being  a  light  brown 


THE  RACIAL  DIVISIONS  OF  MAN 


or  gray,  and  are  set  straight  in  the  head ;  the  nose  is  finely 
shaped  and  slightly  arched,  and  to  American  and  European 
eyes  many  of  them  are  quite  handsome.  Indeed,  the  older 


Fig.  16 — AN  AINO,  THE  "WHITE  MAN"  OF  JAPAN 

men  would  in  many  cases  be  indistinguishable  from  an 
elderly,  well-bearded  man  in  America  or  Europe.  The  hair 
is  Caucasic  in  type.  The  race  is  by  no  means  pure,  and 
has  suffered  deterioration  by  being  constantly  pushed  fur- 


52  ANTHROPOLOGY 

ther  and  further  to  the  edge  of  the  continent,  so  that  their 
only  home  now  is  on  a  few  of  the  Japanese  Islands.  The 
traditions  of  the  Ainos  go  back  to  a  time  when  a  large 
portion  of  the  mainland  was  in  their  possession. 

On  the  opposite  point  of  the  continent,  in  West  Ireland, 
North  Scotland  and  North  Scandinavia,  the  same  type 
appears,  even  more  pure,  for  it  has  not  been  mixed  with 
Mongol  blood.  There  fair — and  even  red — hair  is  to  be 
found,  with  blue  eyes,  orthognathous  jaw,  large  cranial 
capacity  and  the  various  other  marks  distinctive  of  the 
Caucasic  race.  It  would  appear,  therefore,  that  a  white 
race  had  once  lived  in  Europe  and  in  Asia,  which  had  been 
successively  pushed  further  and  further  out  by  later  peo- 
ples, the  white  strain  being  less  adulterated  the  further  it 
migrated  from  the  pursuing  foe,  and  keeping  much  of  its 
purity  only  upon  the  very  verge  of  habitable  land  on  the 
continent.  The  Caucasic,  therefore,  is  not  so  much  the 
White  Race  as  a  true  Caucasian  who  has  made  the  White 
Race  extinct,  but  in  the  doing  so  has  incorporated  with 
himself  the  various  points  of  the  White  Race,  the  mixture 
t>eing  more  Archaean  white  on  the  edges  and  more  Cau- 
casian in  the  center. 

A  Caucasic-Archaean  White  Race,  therefore,  is  definitely 
established,  and  is  to  be  considered  as  a  third  branch  of 
the  human  species,  if  it  is  constantly  borne  in  mind  that 
this  is  a  race  with  a  double  origin  and  that  many  of  the 
apparent  discrepancies  that  occur  in  it  are  due  to  the  vary- 
ing proportions  of  admixture  to  be  found  therein.  The  so- 
called  Aryan  invasion  was  truly  an  invasion  in  every  sense 
of  the  word,  but  by  a  curious  mental  quirk  the  existence  of 
the  peoples  who  were  invaded  have  dropped  largely  out  of 
sight. 

A  still  more  difficult  question  rises,  however,  when  the 
conditions  on  the  American  continent  are  encountered. 
Keane  declares  that  "owing  to  the  absence  of  the  higher 
apes,"  the  New  World  cannot  be  regarded  as  an  inde- 
pendent center  of  evolution  for  Man  himself."  The  first 


THE  RACIAL  DIVISIONS  OF  MAN          53 

part  of  the  statement  is  true  enough,  but  the  conclusion  is 
entirely  without  warranty,  for  no  one  would  declare  more 
certainly  than  Keane  himself  that  Man  is  not  descended 
from  the  higher  apes.  It  has  been  shown  that  Man  in  an 
earlier  period  diverged  from  the  mammalian  stock,  but  it 
is  not  to  be  forgotten  that  he  is  a  branch  from  the  mam- 
mals, not  a  twig  on  a  branch  from  the  apes.  The  distinc- 
tion is  tremendous  and  vital.  It  is  therefore  no  argument 
at  all  to  endeavor  to  dispose  of  the  origin  of  the  paleolithic 
and  neolithic  American  races  by  such  a  statement. 

The  archeological  importance  of  America  is  greatly 
underestimated.  Thus  there  are  good  grounds  for  accept- 
ing a  Paleolithic  Age  in  Patagonia;  there  are  Neolithic 
remains  widely  scattered  over  the  continent ;  there  are  irri- 
gation projects  in  desert  New  Mexico,  once  a  fertile  and 
well-populated  country,  irrigation  canals  made  before  the 
lava  flowed  into  them  3,000  years  ago ;  there  is  a  bronze  age 
in  Chimu,  which  was  overthrown  by  the  Nahoa  invasion — 
bronze,  moreover,  of  a  proportionate  alloy  found  nowhere 
else  in  the  world;  there  are  the  whole  group  of  Aztlan 
civilizations,  of  which  the  later  Aztec,  Toltec  and  Maya  are 
still  a  riddle  unread;  there  are  the  pueblo  tribes,  and  the 
whole  sealed  book  of  the  mound-builders  and  the  makers 
of  the  beehive  hut. 

What  is  not  the  least  strange  of  the  ideas  that  have  pre- 
vailed concerning  the  American  continent  and  its  popula- 
tion is  that  it  must  have  come  from  Europe  or  from  Asia. 
In  order  to  try  and  bolster  up  the  idea  of  the  dependence 
of  America  on  Europe  for  all  she  had,  the  old  story  of  the 
'lost  Atlantis'  was  revamped  and  an  endeavor  made  to  put 
the  tale  on  a  scientific  basis.  But  the  theory  was  never 
worthy  of  the  support  it  gained,  and  it  has  now  passed  to 
the  limbo  of  archaic  beliefs  together  with  the  mandrake 
and  the  roc. 

Scarcely  less  impossible  was  the  idea  that  the  primitive 
Americans — that  is,  the  American  of  paleolithic  times — 
had  crossed  into  this  continent  from  Asia  by  way  of  Beh- 


54  ANTHROPOLOGY 

ring  Straits.  At  first  blush  this  seems  a  probable  theory, 
but  when  the  question  of  glaciation  is  taken  into  considera- 
tion and  it  is  noted  that  the  ice-cap  extended  far  over  the 
American  continent  and  that  the  whole  of  the  northeast 
of  Asia  and  all  the  northwest  of  America  was  an  absolutely 
impassable  ice-barrier,  the  theory  loses  its  appearance  of 
probability.  It  is  to  be  observed  that  this  does  not  apply 
to  recent  immigrants,  to  the  'North  American  Indians' — 
that  is  to  say,  the  Hunting  Tribes,  whose  nomadic  wander- 
ings extended  so  widely  over  the  country;  they  bear  no 
relation  to  the  early  settlers — who  were  not  nomads. 

Sir  Daniel  Wilson,  an  archeologist  who  has  given  much 
attention  to  American  antiquities,  declares  upon  this  point : 
"The  Western  Hemisphere  stands  a  world  apart,  with  lan- 
guages and  customs  essentially  its  own.  To  whatever 
source  American  man  may  be  referred,  his  relation  to  the 
Old  World  races  are  sufficiently  remote  to  preclude  any 
theory  of  geographical  distribution  within  the  historic 
period."  And  again:  "The  studies  of  the  monuments  and 
prehistoric  remains  of  the  American  continent  seem  to 
point  conclusively  to  a  native  source  for  its  civilization. 
From  quipu  to  wampum,  pictured  grave  post  and  buffalo 
robe  to  the  most  finished  hieroglyphs  of  Copan  and  Palen- 
que,  continuous  steps  appear." 

The  absolute  non-coincidence  of  American  remains  is 
the  more  remarkable  when  it  is  borne  in  mind  that  for  so 
many  years  the  endeavor  was  made  to  cause  every  find  to 
be  so  interpreted  as  to  bolster  up  the  theory  of  European 
or  Asian  origin.  Yet  Daniel  G.  Brinton  is  even  more  em- 
phatic. "I  maintain  therefore,  in  conclusion,"  he  said  in 
a  paper  read  before  the  International  Congress  of  Anthro- 
pology, "that  up  to  the  present  time  (1894)  there  has  not 
been  shown  a  single  dialect,  not  an  art  or  an  institution, 
not  a  myth  or  a  religious  rite,  not  a  domesticated  plant  or 
animal,  not  a  tool,  weapon,  game  or  symbol  in  use  in  Amer- 
ica at  the  time  of  the  discovery  which  had  been  previously 


THE  RACIAL  DIVISIONS  OF  MAN 


55 


imported  from  Asia  or  from  any  other  continent  of  the  Old 
World." 

Upon  such  a  basis,  then,  it  would  seem  the  human  spe- 
cies can  be  grouped  into  four  races — the  Negroid,  the 
Mongoloid,  the  Caucasian  and  the  Americ.  The  charac- 
teristics of  the  first  three  are  very  clearly  seen,  that  of  the 
fourth — if  the  Hunting  Tribes  be  omitted — is  very  little 
known. 

It  may  be  objected  that  there  is  no  sure  evidence  what 
was  the  racial  division  thousands  of  years  ago.  To  this 
P.  Topinard,  in  his  'Anthropology/  may  answer.  "Whether 
assisted  or  not  by  archeology,"  he  says,  "history  narrates 
that,  under  the  Twelfth  Dynasty,  about  2300  B.C.,  the 


Fig.  17 — RACES  KNOWN  3,000  YEARS  AGO 

Egyptians  consisted  of  four  races :  ( i )  The  'Rot,  'or  Egyp- 
tians, painted  red  and  similar  in  feature  to  the  peasants 
now  living  on  the  banks  of  the  Nile;  (2)  the  'Namahu/ 
painted  yellow,  with  the  aquiline  nose,  corresponding  to 
the  population  of  Asia  to  the  east  of  Egypt;  (3)  the 
'Nahsu,'  or  prognathous  negroes,  with  woolly  hair;  (4)  the 
'Tamahu/  whites,  with  blue  eyes." 

Thus,  taking  under  consideration  the  Black  Race  first, 


56  ANTHROPOLOGY 

as  it  is  the  most  strongly  differentiated,  a  possibly  satis- 
factory division  might  be  made  much  as  follows : 


Black. 


Negrillos. 


/Bushmen 
"  I  Pigmies 


I  Soudanese 

Negroes -|  Senegambians 

[Guineans 


Islanders. 


Negritos 

Papuans 

Australians 

Tasmanians 

Gonds 


The  Negrillo  division  of  the  Black  Race  includes  those 
types  of  men  which  present  dwarfish  characteristics.  Of 
these  the  two  best-known  examples  are  the  South  African 
Bushmen  and  the  Pigmies.  Both  of  these  are  of  diminu- 
tive stature,  the  average  height  being  under  five  feet,  and 
certain  stunted  tribes  showing  an  average  of  less  than  four 
and  a  half  feet.  The  skin  is  very  hard  and  much  wrin- 
kled; the  nature  is  ferocious  but  without  persistency;  the 
birth  rate  is  immense,  a  single  child  at  birth  being  rare 
and  triplets  and  quadruplets  common;  but  the  death  rate 
is  equally  large,  and  longevity  is  absolutely  unknown. 
They  are  dull  black  in  color,  the  ear  is  small  and  ape-like, 
and  the  arms  long. 

The  Negroes  proper  include  those  tribes  which  are 
found  at  their  best  in  the  upper  reaches  of  the  White  Nile 
and  about  the  Nyassas.  In  contradistinction  to  the  dwarf- 
ish Negrillos,  they  are  usually  of  large  stature  with  a  fair 
muscular  frame.  They  extend  from  the  fine  race  of  the 
Gabooners  in  the  north  to  the  equally  representative  Zulus 
in  the  extreme  south.  The  Nile  tribes,  true  negroes,  are 
of  an  intense  glossy  blackness  in  color,  different  entirely 


THE  RACIAL  DIVISIONS  OF  MAN          57 

from  the  sootiness  of  the  Negrillos,  and  unlike  their  dwarf- 
ish racial  co-mates,  they  are  inert  and  heavy  in  character, 
possessing  little  ferocity  or  cunning  and  susceptible  of 
little  improvement.  The  Senegambians,  while  possessing 
the  essential  traits  of  prognathism,  thick  lips,  receding 
forehead,  coarse  but  very  white  teeth  and  frizzled  hair,  are 
slightly  less  negroid  in  character;  the  ramifications  of  the 
branch  are  very  extensive,  and  they  alone  among  the 
Black  Races  have  given  evidence  of  a  possibility  of  prog- 
ress. The  Guineans  comprised  the  tribes  from  which  the 
slaves  usually  were  drawn.  They  are  more  docile  in  char- 
acter, less  prognathous  in  jaw,  and  their  color  is  less  inter- 
penetrative than  that  of  the  Nile  tribes,  but  they  are  none 
the  less  distinctly  a  separate  branch  of  the  Black  Race. 

The  Islanders  is  a  loose  term  embracing  a  group  of 
tribes,  many  quite  divergent,  which  are  spread  over  the 
islands  of  the  South  Seas.  The  Negritos — of  whom  the 
Andaman  islanders  are  the  best  example — are  in  some 
measure  a  mixed  race,  but  are  unquestionably  negroid. 
They  disclose  in  especial  excess  the  splay  feet  character- 
istic of  the  Black  Race  and  the  protruding  heel.  The 
Papuans  are  probably  the  root-stock  of  the  two  following 
subdivisions,  the  Tasmanians  and  the  Australians,  and  they 
are  a  very  distinctive  type.  Indeed,  for  many  years  they 
were  classed  as  a  separate  race,  but  this  position  largely 
has  been  abandoned.  They  are  by  far  the  most  intelligent 
of  the  Islanders  and  are  distinguished  very  largely  by  their 
most  characteristic  hair,  which,  throughout  all  the 
branches  of  the  division  grows  very  abundantly  and  very 
long,  possesses  a  curiously  flattened  structure  and  has  a 
peculiarity  of  separating  into  tufts  of  great  thickness  and 
strength.  The  jaws  are  less  prominent  than  those  of  the 
Negroes  proper  and  the  lips  more  shapely.  The  nose  is 
notably  unlike,  being  long  and  not  too  broad.  The  legs, 
long  and  thin,  possess  a  distinct  resemblance  to  those  of 
the  Negrillos,  tho,  of  course,  on  a  larger  scale.  The  divi- 
sion of  Gonds  includes  those  aboriginal  tribes  of  India 


53  ANTHROPOLOGY 

whose  presence  there  is  so  difficult  of  explication,  but  of 
whose  racial  characteristics  as  members  of  the  Black  Race 
there  seems  good  evidence. 

A  consideration  of  the  Yellow  Race  might  lead  to  a 
general  division  as  follows : 

("Thibetan 
Indo-Chinese -j  Chinese 

[Malay 
Yellow.  ~~ 

fManchu 
Tartar J  Turk 

[  Samoyedes 

The  divisions  of  the  Yellow  Race  are  less  confused. 
There  are  two  main  divisions,  the  Indo-Chinese  and  the 
Tartar,  and  between  these  two  the  difference  is  wide.  The 
Yellow  Race  is  characterized  by  long,  straight  black  hair, 
which  is  nearly  cylindrical  in  section,  "by  a  nearly  com- 
plete absence  of  beard  and  hair  on  the  body,  by  a  dark- 
cc^ored  skin,  varying  from  a  leather-like  yellow  to  a  deep 
brown  or  sometimes  tending  to  red,  and  by  prominent 
cheek-bones,  generally  accompanied  by  an  oblique  setting 
of  the  eyes." 

Of  these  the  Thibetans  seem  to  represent  a  fairly  pure 
stock,  their  isolation  having  contributed  much  thereto,  and 
which  renders  them  closely  allied  to  certain  of  the  Malay 
tribes  of  the  Indo-Chinese  group.  The  Malay  is  a  widely 
spread  branch  and  has  proved  one  readily  susceptible  of 
change.  Spreading  from  the  most  distant  South  Sea  isl- 
ands to  Madagascar  and  Ceylon,  it  has  left  an  imprint  on 
the  entire  population  of  Oceanica  which,  by  reason  of  its 
division  into  innumerable  islands,  had  no  opportunity  to 
retain  homogeneity. 

The  second  great  branch  of  the  Indo-Chinese  is  the  Chi- 
nese proper.  It  is  greatly  subdivided,  but  is  strongly 
marked  by  racial  as  well  as  national  characteristics.  Sub- 


THE  RACIAL  DIVISIONS   OF  MAN          59 

tended  by  the  Malays  and  Thibetans,  it  has  partaken  of  the 
natures  of  each  of  these,  and  provinces  in  China  possess 
delimitations  which  have  become  extremely  broad  as  the 
result  of  the  density  of  the  population  and  the  scarcity  of 
travel.  The  intrusion  of  Tartar  blood  of  the  Manchu  line 
(the  Manchu  is  now  the  reigning  dynasty  of  China)  has 
further  complicated  the  condition  of  China,  so  that  even 
the  different  strata  of  society  in  the  same  province  will 
present  problems  of  intermittent  difficulty. 

In  addition  to  the  Manchu  division  of  the  Tartar  branch, 
there  is  a  large  group  known  as  the  Turks.  These  are  the 
true  dwellers  of  Turkestan,  and  there  is  a  strong  admixture 
of  this  blood  in  the  Beloochis  and  other  tribes  on  the  north- 
ern side  of  the  Himalayas;  mixed  to  a  certain  extent  (not 
great)  with  Aryan  ancestral  traits,  they  form  the  basic 
stock  for  the  Turks  of  the  Ottoman  Empire.  The  Cossacks 
are  true  Tartars  and  seem  closely  allied  to  the  Manchu, 
with  a  strong  crossing  of  Turkish  heritage.  The  third 
group  is  the  Arctic  or  Samoyedic,  a  widely  spread  section 
of  the  Tartar  race,  including  Lapps,  Finns  and  in  the  most 
divergent  example,  the  Eskimo. 

The  Yellow  Race  thus  dominates  the  entire  continent  of 
Asia,  except  Hindostan  and  Arabia,  and  besides  sweeps 
half  way  down  through  Oceanica.  There,  in  the  South  Sea 
archipelagoes,  it  encounters  the  Islander  branch  of  the 
Black  Race,  which  in  its  turn  has  covered  the  entire  conti- 
nent of  Africa  south  of  the  Sahara  and  its  share  of 
Oceanica.  Such  a  partition,  it  is  evident,  is  not  only  eth- 
nological but  also  ethnographical. 

Complex  as  the  inter-tribal  relations  of  the  Black  and 
Yellow  Races  have  been,  the  intermingling  of  the  White 
Races  has  been  much  greater,  and  consequently  the  differ- 
ences between  them  more  slight.  In  the  classification  of 
the  White  Race  that  is  given  below,  the  old  Noachite  terms 
have  been  used,  because,  as  is  well  known,  the  distribution 
of  the  White  Races  does  follow  in  a>  manner  similar  to  the 


6o 


ANTHROPOLOGY 


traditional  wandering  of  the   sons   of  Noah.     It   is   still 
popularly  held.     This  classification  is  as  follows: 


White. 


Hamitic. 


Semitic. 


Japhetic. 


f  Berbers 
.-<  Egyptians 
[Somali 

fArabian 
.  -j  Abyssinian 
[Hebrew 


Celtic 

Teutonic 

Slavic 

Italic 

Iranian 


The  Hamitic  nations  now  have  fallen  to  a  comparatively 
unimportant  place  among  the  White  Races,  but  in  the  early 
days  of  civilization  they  were  the  leading  peoples  of  the 
world.  The  Assyrians,  the  early  Egyptians  and  the  Pheni- 
cians  were  all  Hamites.  The  lonians  of  the  time  of  Homer 
belong  in  the  same  group  and  had  no  small  influence  on 
the  Hellenes  of  later  dates,  and  the  Etruscans  were  but 
little  changed  from  the  primal  stock. 

The  Semitic  grandeur  also  has  largely  disappeared.  The 
Arabs,  the  Abyssinians  and  the  Hebrews  chiefly  remain 
of  this  once  powerful  branch,  which  led  all  Oriental  cul- 
ture in  its  Chaldean  power.  The  Elamites  and  the  great 
conquerors  of  the  Second  Assyrian  Empire  were  Semites, 
but  perhaps  what  has  always  been  the  most  distinguishing 
force  of  this  line  of  the  White  Races  has  been  its  capacity 
for  being  absorbed  into  other  peoples,  and  yet  in  its  very 
process  of  absorption  Semitizing  the  alien  peoples  them- 
selves. 

The  Japhetic  branch  of  the  White  Race  is  that  which  is 
dominant  to-day.  Where  lines  of  divergence  are  as  nar- 


THE  RACIAL  DIVISIONS   OF  MAN          61 

row  as  in  the  case  of  this  branch  of  the  human  family,  it 
avails  best  to  make  as  clear  a  subdivision  as  possible  by 
the  old  linguistic  methods.  On  such  a  basis  five  lines  may 
be  cited.  Probably  the  purest  and  most  primitive  is  the 
Celtic  line,  the  earliest  to  diverge,  and  constantly  driven 
westward,  so  that  it  is  now  confined  to  the  interior  and 
south  of  Ireland  and  parts  of  the  west  coast ;  the  highlands 
of  Scotland;  the  mountain  fastnesses  of  Wales  and  the 
coasts  of  Brittany  and  Normandy,  France,  speaking  the 
languages  respectively  of  Erse,  Gaelic,  Welsh,  Breton  and 
Armorican.  The  true  type  seems  to  persist  in  a  union  of 
dark  hair  with  light  gray  and  blue  eyes  and  a  fair  com- 
plexion (the  flaxen-hair  is  an  Archaean  trait).  The  na- 
ture is  impulsive,  imaginative  and  chivalrous,  but  too  in- 
dividualistic to  permit  of  national  unity. 

The  Teutonic  peoples  are  the  antithesis  of  the  Celts. 
Their  language  has  had  so  formative  an  effect  on  all  other 
language  used  by  the  White  Race,  that  its  limits  are  vague 
and  ill-defined.  The  old  Maeso-Gothic,  the  foundation  of 
the  German  language,  was  a  Teutonic  tongue,  and  high 
German  to-day  is  the  best  example  of  the  type.  The  im- 
press is  extremely  strong  on  the  English  language  and  the 
composite  Anglo-Saxon  is  in  by  far  the  largest  proportion 
Teutonic.  Where  the  Celt  is  imaginative  the  Teuton  is 
solid;  the  Celtic  impulsiveness  is  opposed  by  the  Teutonic 
prudence,  and  wherever  this  phlegmatic  race  has  abided, 
self-government  and  the  arts  of  peace  abound.  The  flaxen- 
haired,  large-limbed  Scandinavian  is  the  extreme  of  the 
Teutonic  type  of  physical  frame,  so  far,  at  least,  as  can 
now  be  discerned. 

The  Italic  group  is  of  clear  outline.  It  embraces  the 
nations  speaking  languages  generally  known  as  the  "Ro- 
mance languages,"  and  comprises  the  nations  along  the 
northern  shores  of  the  Mediterranean.  The  military 
regime  of  the  Roman  Empire,  which  was  of  Italic  stock, 
wrought  a  profound  effect  upon  the  destinies  of  southern 
Europe  and  stamped  its  language  indelibly  upon  the 


62  ANTHROPOLOGY 

speech  of  Man.  The  assimilation  by  the  later  Romans  of 
barbarian  blood,  weakened  its  permanence  as  a  matter  of 
physical  differentiation.  The  character  is  passionate, 
vengeful  and  pleasure-loving,  and  by  its  readiness  to  con- 
sider only  the  things  of  the  moment,  capable  of  being  di- 
rected to  great  deeds  by  capable  leaders.  The  type  is  olive- 
skinned,  with  dark  brown  and  black  eyes  and  a  very  glossy 
hair. 

The  Slav  sphere  is  of  clear  contour.  The  Russian  since 
his  first  settlement  has  adopted  a  policy  of  exclusiveness 
to  neighboring  races  and  possesses  no  ability  to  colonize. 
His  language  and  customs  are  strongly  individualized  and 
stereotyped  and  literature  is  scanty.  Tho  possessing  abili- 
ties of  a  high  order,  the  Slav  is  notable  for  a  morbidness 
of  temperament  and  a  non-adaptability  to  progression 
which  has  isolated  him  from  the  world  about  him.  A 
rigid  class-demarcation,  added  to  this  immobility  of  condi- 
tions has  led  to  stratified  physical  types,  but  in  general  it 
may  be  said  that  the  Slav  is  well-built,  regular-featured 
and  possessed  of  an  unusually  luxuriant  growth  of  hair. 

Last  comes  the  Iranian,  probably  the  only  branch  of  the 
parent  stock  to  deviate  from  the  general  westward  trend. 
The  Iranians  traveled  southeasterly  and  passed  over  Persia 
into  India.  The  great  Oriental  civilizations  were  theirs, 
the  vast  literature  of  Sanskrit  is  Iranian,  and,  moreover, 
the  Iranian  imprint  upon  southern  Asia  is  that  which  has 
made  it  so  entirely  different  in  scope  and  mental  attitude 
from  the  Asia  north  of  the  Himalayas. 

On  such  debatable  ground  as  the  origin  of  races,  state- 
ments must  be  cautiously  made.  Briefly,  there  are  two 
schools,  the  one  known  as  'polygenists'  holding  that  the 
races  of  Man  were  evolved  as  a  result  of  almost  similar 
conditions  in  various  parts  of  the  globe,  and  that  the 
causes  of  this  variation  are  the  difference  of  his  origin 
and  of  his  environment.  The  other  school,  the  mono- 
genists,  hold  that  Man  was  descended  from  a  single  pair 
of  ancestors,  or,  it  may  be,  a  single  group,  and  that  all 


THE  RACIAL  DIVISIONS   OF  MAN          63 

the  variations  of  race  have  been  brought  about  through 
environment  alone.  To  this  latter  view  may  be  added 
the  hypothesis  that  Nature  acts  'per  saltum/  'by  jumps/ 
and  getting  tired  of  having  yellow  parents  produce  yel- 
low children,  she  varied  the  program  and  arranged  for 
one  pair  to  be  Negro.  Anthropologists  are  almost  evenly 
divided,  tho  perhaps  the  majority  may  be  slightly  in  favor 
of  monogeny.  The  present  writer  holds  with  the  polyge- 
nistic  school,  for  the  reason  that  extensive  migrations 
over  glaciated  areas  in  glacial  times  afford  too  many 
difficulties;  but  it  is  not  desired  to  deal  here  with  a  sub- 
ject calculated  to  provoke  controversy. 

The  question  always  will  be  a  difficult  one,  for  the  rea- 
son that  the  geological  record  is  not  perfect,  and  the 
paleontological  record  of  man  still  less  so.  Just  where 
the  Man  left  the  mammalian  stem,  and  whether  it  was 
'per  saltum/  or  through  gradual  process;  whether  it  will 
be  found  that  all  races  of  Man  approach  more  nearly 
to  a  persistent  type  in  the  anthropoid  ape,  or  whether 
certain  races  of  Man  will  be  found  more  nearly  allied  to 
certain  different  varieties  of  fossil  ape,  are  questions 
likely  to  be  long  of  solution,  for  the  answer  may  lie  deep 
in  some  filled-up  mountain  valley  or  in  the  bed  of  some 
marine  or  lacustrine  basin. 


CHAPTER  V 

PREHISTORIC    ARCHEOLOGY 

GREATER  libraries  than  the  world  has  ever  dreamed  of 
lie  under  foot,  and  scarce  a  fraction  of  the  treasures  of 
archeology  have  been  exhumed  from  the  strata  wherein 
they  lie.  All  know  well  the  thrill  of  excitement  which 
pulsates  over  a  community — yes,  over  the  whole  world — 
when  a  discovery  of  gold  is  made,  yet  such  is  but  a  po- 
tential treasure  for  a  few  men,  and  is  soon  spent,  while 
a  'find'  of  true  archeological  worth  is  a  treasure  for  all 
men  and  all  ages  to  come. 

Ruined  palaces  and  fortresses,  revealing  tales  more 
strange  than  any  fairy  story  has  yet  given  to  the  world, 
hide  in  the  dense  forests  of  Yucatan;  cryptic  puzzles,  as 
yet  unread,  clamor  for  attention  to  all  the  world  from 
the  highway  of  Salisbury  Plain,  England ;  dim  shadowings 
of  the  life  of  the  Troglodyte  come  forth  from  the  caverns 
of  the  Dordogne  in  France;  while  in  every  country  are 
to  be  found  the  remains  of  Man  side  by  side  with  the 
gigantic  animals  of  an  earlier  time,  bidding  moderns  seek 
them  and  reconstruct  the  wonders  of  that  ancient  age 
when  the  ancestors  of  the  present  races  waged  their  won- 
derful war  for  life. 

In  every  department  of  human  thought  the  students 
thereof  feel  themselves  to  be  working  on  the  subject  which 
is  of  the  chiefest  importance  and  of  transcendent  inter- 
est, but  the  archeologist  affirms  as  reason  for  his  plea 
that  all  these  sciences,  all  these  arts,  belong  to  him,  and 

64 


PREHISTORIC   ARCHEOLOGY  65 

that  the  gropings  of  Man  and  the  development  of  Man 
\long  all  lines  are  but  superstructures  upon  the  founda- 
;ion  he  is  laying.  Neither  is  he  confined  to  race,  to  pe- 
riod, or  to  type;  if  his  taste  runs  to  the  small  detail,  he 
may  spend  his  years  deciphering  the  most  minute,  semi- 
obliterated  inscription  on  a  stone;  or,  if  he  so  prefers,  he 
may  stand  below  cyclopean  walls  and  tell  the  world  who 
made  them  and  how  they  were  erected  in  their  grandeur. 

In  its  truest  sense  of  the  word,  Prehistoric  Archeology- 
is  comparatively  a  new  science.  For  many  thousand 
years  men  cared  little  for  the  history  of  any  save  their 
own  country,  and  even  until  very  recently  all  history- 
taught  in  the  schools  began  with  Greece  and  Rome.  But 
the  reading  of  the  hieroglyphic  inscriptions  of  Egypt  and 
of  Babylon  during  the  last  fifty  years  forced  upon  the 
attention  of  thinking  people  the  fact  that  history  must 
be  vastly  more  ancient,  and  to  modern  views  the  wars 
between  Athens  and  Sparta  were  combats  of  yesterday. 

Linguistic  difficulties  next  arose,  and  it  was  pointed  out 
that  many  centuries  must  have  elapsed  before  so  complete 
a  system  as  the  hieroglyph  and  the  cuneiform  were  seen 
to  be  could  have  evolved  from  primitive  man.  The  grad- 
ual development  of  the  arts  likewise  formed  a  puzzle  to 
the  historian,  and  the  date  of  Man  was  pushed  ever 
further  and  further  back. 

The  evolutionary  hypothesis,  or  the  Law  of  Evolution, 
as  it  now  has  a  right  to  be  named,  of  course,  was  that 
which  changed  the  whole  aspect  of  history.  Instead  of 
Man  being  a  strange  creature,  made  in  half  a  dozen 
molds  by  a  supernatural  hand,  and  given  a  higher  degree 
of  civilization,  from  which  he  afterward  fell,  it  became 
clear  that  Man  has  risen,  not  fallen.  Only  a  slight  knowl- 
edge of  science  was  needed  to  show  that  the  rise  would 
increase  in  rapidity  with  later  advances,  and  consequently 
would  decrease  in  antiquity,  so  that  the  earliest  faltering 
;steps  of  Man  in  any  direction  must  have  been  slow. 

When,  therefore,  the  historian,  looking  back  into  the 


66  ANTHROPOLOGY 

past,  began  to  compare  his  earliest  dates  with  the  appar- 
ent dates  of  the  first  appearance  of  Man  upon  the  earth, 
he  hastily  broke  company  with  a  'historian  of  antiqui- 
ties/ and  gave  place  to  the  modern  prehistoric  archeolo- 
gist,  who  presents  his  science  from  the  actual  evidence 
of  tangible  objects  themselves.  Prehistoric  anthropolo- 
gists have  investigated  these  objects  and  the  various  de- 
posits containing  them  as  to  (i)  their  human  origin, 
(2)  the  geologic  age  of  the  stratum  in  which  they  are 
found,  (3)  their  original  deposit  in  that  stratum  at  the 
time  it  was  formed  (that  is  to  say,  an  absence  of  intru- 
sion or  disturbance),  (4)  the  association  and  superposi- 
tion of  the  implements  and  objects  in  the  stratified  de- 
posits; and  by  the  knowledge  and  experience  thus  ob- 
tained they  have  determined  that  man  made  these  objects, 
and,  therefore,  he  existed  in  these  localities  in  times  of 
high  antiquity. 

Prehistoric  Archeology  deals  with  three  periods,  known 
respectively  as  the  Paleolithic,  the  Neolithic,  and  the 
Bronze  Age.  They  are  each  distinct  from  each  other, 
altho  the  latter  two  show  a  certain  amount  of  over- 
lapping that  is  to  be  expected.  But  there  is  no  evidence 
of  a  Neolithic  race  ever  having* gone  back  to  Paleolithic 
methods,  nor  is  there  a  case  of  a  people  which  has 
learned  to  use  metal  that  readily  resumed  the  habitude 
of  stone. 

It  is  unquestionably  true  that  the  development  of  the 
various  races  that  have  been  mentioned,  the  Negroid, 
the  Mongoloid,  the  Caucasic  and  the  Americ,  followed 
slightly  different  channels  at  widely  different  speeds,  so 
that  the  three  ages  will  be  found  to  synchronize  in  point 
of  time  with  three  peoples  who  may  not  be  far  distant 
from  each  other.  Thus,  it  would  be  absurd  to  speak  of 
the  English  at  the  Battle  of  Hastings — after  such  liter- 
ary works  as  the  'History  of  Alfred  the  Great' — as  being 
Paleolithic  or  Neolithic  Man,  yet  it  is  unquestionable 


PREHISTORIC   ARCHEOLOGY  67 

that  stone  battleaxes  were  used  against  the  Norman  in- 
vaders. 

The  nature  of  the  remains  of  Primitive  Man  were  col- 
lated by  Sir  John  Lubbock  (Lord  Avebury)  in  his  'Pre- 
historic Times/  when  he  said,  "Archeology  forms,  in  fact, 
the  link  between  geology  and  history.  It  is  true  that  in 
the  case  of  other  animals  we  can,  from  their  bones  and 
teeth,  form  a  definite  idea  of  their  habits  and  mode  of  life, 
while  in  the  present  state  of  our  knowledge  the  skeleton 
of  a  savage  could  not  always  be  distinguished  from  that 


Fig.  18 — FLINT  KNIVES  REPLACED  ON  BLOCK  FROM  WHICH  THEY 
HAD  BEEN  CHIPPED  OFF 

of  a  philosopher.  But  on  the  other  hand,  while  other  ani- 
mals leave  only  teeth  and  bones  behind  them,  the  men 
of  past  ages  are  to  be  studied  principally  by  their  works: 
houses  for  the  living,  tombs  for  the  dead,  fortifications 
for  defense,  temples  for  worship,  implements  for  use,  and 
ornaments  for  decoration." 

But  it  will  immediately  appear  evident  that  all  such 
investigation  will  depend  very  largely  upon  the  location  in 
which  such  finds  are  made;  indeed,  it  will  depend  almost 


68  ANTHROPOLOGY 

entirely  upon  such  fact.  When  a  flint  scraper,  however,  is 
found  in  a  river-drift  or  gravel-bed,  which,  so  far  as  can 
be  discovered,  has  never  been  disturbed,  it  may  be  taken 
as  a  fair  assumption  that  the  scraper  and  the  gravel  were 
laid  down  together.  When,  moreover,  that  same  strata 
contain  a  great  number  of  such  finds,  the  probabality  be- 
comes stronger.  When,  yet  again,  those  scrapers  are 
found  close  beside  the  bones  of  some  animal  now  extinct, 
but  which  lived  upon  the  earth  at  the  time  that  gravel 
bed  was  being  laid  down,  the  probability  becomes  assured; 
and  when  this  juxtaposition  is  supported  by  similar  finds 
in  similar  strata,  probability  becomes  certainty. 

Speaking  broadly,  the  materials  now  available  for  the 
study  of  primitive  man  are  threefold,  'his  implements,  his 
monuments,  and  himself/  The  first,  from  which  he  rightly 
takes  his  name  of  Paleolithic  Man,  are  in  some  respects 
the  most  important,  as  being  immeasurably  the  most  nu- 
merous and  widespread,  but  chiefly  because  they  often 
occur  under  conditions  which  afford  the  best  proof  of 
their  artificers'  extreme  antiquity.  The  monuments,  if 
such  undesigned  structures  as  shell-mounds  or  kitchen- 
middens  may  for  convenience  be  so  named,  lie  necessarily 
on  the  surface,  or  at  most  on  raised  beaches,  while  the 
fossil  remains  of  man  himself  have  been  found  almost 
exclusively  amid  the  general  contents,  or  at  most  under 
the  stalagmite  floors  of  his  cave-dwellings. 

If,  then,  the  use  of  stone  for  implements  was  one  of 
the  most  important  lines  of  useful  knowledge  possessed 
by  early  Man,  it  becomes  important  to  find  out  what  was 
the  stone  so  used  and  the  reason  for  its  selection.  The 
two  stones  most  commonly  used  were  jade  and  flint,  and 
these,  accordingly,  are  found  sometimes  at  long  distances 
from  any  place  where  the  unworked  material  could  have 
been  secured,  showing  either  that  there  was  some  form 
of  commerce  in  the  earliest  times,  or  that  the  nomadic 
life  of  the  Paleolithic  Man  caused  him  to  traverse  great 
distances. 


PREHISTORIC   ARCHEOLOGY  69 

It  is  remarkable  how  carefully  the  best  kinds  of 
stone  were  selected,  even  when  very  rare.  Of  this  the 
most  interesting  example  is  afforded  by  the  axes,  etc., 
of  Jade  or  Nephrite,  of  Jadeite  and  of  Saussurite.  These 
minerals  are  very  distinct  chemically,  but  so  similar  in 
appearance  that  they  can  only  be  distinguished  by  analy- 
sis. Objects  made  from  them,  tho  far  from  common,  are 
not  very  rar'e.  Thousands  of  Jadeite  implements  and 
ornaments  have  been  found  in  Central  America,  but  no 
deposit  has  yet  been  discovered;  and,  indeed,  the  Jadeite 
which  has  been  used  is  of  so  uniform  a  texture  and  chem- 
ical composition  that  it  seems  as  tho  all  of  it  had  been 
quarried  from  the  same  bed. 

Flint  was  the  material  most  commonly  used,  but  every 
kind  of  stone,  hard  and  tough  enough  for  the  purpose,, 
was  used  during  the  .Stone  Age  in  the  manufacture  of 
implements,  some  even  harder,  but  few  wherein  the  lines 
of  cleavage  were  better  adapted.  Prehistoric  Man  valued 
flint  on  account  of  its  hardness  and  mode  of  fracture, 
which  is  such  that,  with  practice,  a  good  sound  block 
can  be  chipped  into  almost  any  form  that  may  be  re- 
quired. 

Paleolithic  implements  abound  in  the  drift  gravels;  the 
surface  is  strewn  with  flint  flakes  and  fragments  of  flint 
implements;  and  at  the  present  time  "Grimes. Graves  is  the 
only  place  in  England  where  gun-flints  are  still  made.  For 
this  purpose  one  particular  layer  of  flint  is  found  to  be 
well  adapted,  on  account  of  its  hardness  and  fineness  of 
grain;  while  another  layer,  less  suitable  for  gun-flints, 
is  known  as  "wall-stone,"  'being  much  used  for  building 
purposes. 

"It  is  interesting  to  find,"  says  Sir  John  Lubbock,  "that 
even  in  very  early  times  the  merits  of  the  gun-flint  layer 
were  well  known  and  appreciated;  for  altho  there  is 
abundance  of  flint  on  the  surface,  the  ancient  flint-men} 
sank  their  shafts  down  past  the  layer  of  'wall-stone/ 
which  occurs  at  a  depth  of  nineteen  and  one-half  feet4 


70  ANTHROPOLOGY 

to  the  gun-flint  layer,  which  at  the  spot  in  question  is 
thirty-nine  feet  deep." 

In  one  case  the  roof  of  a  passage  had  given  way.  On 
removing  the  chalk  which  had  fallen  in  the  end  of  the 
gallery  came  in  view.  The  flint  had  been  hollowed  out 
in  three  places,  and  in  front  of  two  of  these  recesses 
pointing  toward  the  half-excavated  stone,  were  two  deer- 
horn  picks,  lying  just  as  they  had  been  left,  still  coated 
with  chalk  dust,  on  which  was  in  one  place  plainly  visible 
the  print  of  the  workman's  hand.  The  tools  had  evidently 
been  left  at  the  close  of  a  day's  work;  during  the  night 
the  gallery  had  fallen  in,  and  they  had  never  been  re- 
covered. 

"It  was  a  most  impressive  sight,"  says  Greenwell,  who 
made  the  discovery,  "and  one  never  to  be  forgotten,  to 
look,  after  a  lapse,  it  may  be,  of  3,000  years,  upon  a 
piece  of  work  unfinished,  with  the  tools  of  the  workmen 
still  lying  where  they  had  been  placed  so  many  centuries 
ago." 

The  earliest  manifestations  of  human  art  consisted  of 
the  chipping  of  implements  of  flint,  practically  the  first 
known  to  have  been  made  or  used  by  man.  They  belong 
to  the  Paleolithic  period  of  the  Stone  Age.  This  period 
has  been  divided  according  to  progress  in  human  culture, 
and  divers  names  have  been  given  thereto,  following  the 
taste  of  the  writers  or  discoverers.  M.  Lartet  named 
the  epochs  after  the  animals  associated  with  the  imple- 
ments, and  called  them,  respectively,  the  epochs  of  the 
Cave  Bear,  the  Mammoth,  and  the  Reindeer.  M.  Dupont, 
of  Belgium,  divided  it  into  only  two,  and  named  the 
epochs  after  the  Mammoth  and  the  Reindeer.  M.  de 
Mortillet  has  divided  it  into  five  epochs,  and  has  named 
them,  respectively,  the  Chelleen,  after  the  station  of 
Chelles,  a  few  miles  east  of  Paris ;  the  Acheuleen,  after  St. 
Acheul  on  the  river  Somme ;  the  Mousterien,  after  the 
caverns  of  Moustier  on  the  river  Vezere,  Dordogne;  the 
Solutreen,  after  the  rock  shelter  of  Solutre  near  Macon; 


PREHISTORIC   ARCHEOLOGY  71 

and  the  Madelainien,  after  the  rock  shelter  of  La  Made- 
laine,  Dordogne. 

The  peculiar  characteristic  of  the  implements  of  the 
Paleolithic  period  is  that  man's  cutting  implements,  usu- 


Fig.   19 — EARLIEST  STONE  IMPLEMENTS — (Chelleen). 

Chipped  flakes  of  quartzite  from  India  and  Africa ;  of  flint  from 
France  and  England. 

ally  of  stone,  preferably  flint,  were  made  by  chipping. 
In  the  later  epochs  of  the  Paleolithic  period  certain  im- 
plements were  made  of  bone  and  horn,  which  were  ground 
or  smoothed,  while  those  of  stone  were  not.  It  is  not, 


72  ANTHROPOLOGY 

however,  to  be  supposed  that  every  chipped  stone  imple- 
ment belonged  to  the  Paleolithic  period,  for  the  prehistoric 
man  of  the  Neolithic  period  chipped  many  implements  of 
stone.  Yet  E.  B.  Tylor,  in  his  'Anahuac/  points  out  that 


Fig.  20 — AMERICAN  FLINT  IMPLEMENTS — (Mousterien). 

force  was  probably  also  used  and  describes  a  process  he 
saw  in  operation  on  flakes  of  obsidian. 

The  flint  implements  of  the  Chelleen  period  are,  as  is 
to  be  expected,  extremely  rough,  and  those  that  are  shown 


PREHISTORIC   ARCHEOLOGY  73 

are  presented  with  both  front  and  side  views  to  ernpha-* 
size  the  difference  between  them  and  the  thinner  imple- 
ments which  followed.  Oval  in  shape,  they  possess  a 
distinct  cutting  edge  at  the  point,  and  the  general  shape 
was  that  of  a  plum  stone,  a  few  being  of  a  sharper  curve 
like  an  almond.  It  is  not  to  be  supposed  that  these  were 
determined  differences,  but  rather  were  dependent  upon 
the  nature  of  the  original  fracture. 

But  implements  of  this  character  are  found  widely 
spread,  altho — and  this  is  worthy  of  profound  atten- 
tion— they  are  not  found  in  northern  countries  which 
were  under  the  ice-cap.  In  the  United  States,  while 
it  cannot  be  stated  that  their  nature  is  such  as  to  de- 
mand precisely  the  same  conclusions  that  have  been 
reached  in  Europe,  yet  Thomas  Wilson,  in  his  'Prehis- 
toric Art/  seems  justified  in  saying:  "It  is  apparent 
on  slight  inspection  that  these  implements  found  in  the 
United  States,  altho  mostly  on  the  surface,  are  of 
the  same  Paleolithic  type  as  those  found  in  the  gravels 
of  Europe  and  elsewhere." 

The  Cavern  Period,  as  following  upon  the  Drift,  shows 
a  distinct  advance.  "It  appears  certain,"  says  Wilson, 
"that  there  was  at  the  beginning  of  this  epoch  a  material 
change  in  human  art  and  industry.  The  Chelleen  and  St. 
Acheuleen  implements,  so  widespread,  were  superseded 
by  objects  now  found  in  the  caves  and  rock  shelters  occu- 
pied by  man.  This  statement  might  be  doubted  if  it  rested 
on  a  few  objects,  but  its  truth  will  be  apparent  when  we 
consider  that  these  implements  have  been  found  through- 
out western  Europe  by  hundreds  of  seekers,  in  thousands 
of  places,  and  to  the  number  of  tens  of  thousands,  but 
'never  associated'  with  'cave  implements'  or  objects;  while 
on  the  other  hand,  tens  of  thousands  of  cavern  imple- 
ments and  objects  have  been  found  in  their  appropriate! 
places  and  never  associated  'with  Chelleen  or  St.  Acheu- 
leen implements/  I  say  'never' — if  any  have  been  thus 


PREHISTORIC   ARCHEOLOGY  75 

found,  the  proportion  is  insignificant,  not  one  in  a  hun- 
dred, so  that  the  statement  is  substantially  true." 

The  art  of  flint  chipping  has  never,  in  prehistoric  times, 
nor  among  prehistoric  or  savage  peoples,  attained  a  higher 
degree  of  excellence  than  during  the  Solutreen  epoch. 
There  seems  to  have  been  an  evolution  from  the  rude 
and  heavy  Chelleen  implements  up  to  the  fine  Solutreen 
leaf-shaped  blades.  What  time  elapsed  between  the  two 
there  is  no  means  of  determining;  it  is  to  be  counted  by 
geologic  epochs,  and  not  by  years  or  centuries.  There 
was  a  regular  and  steady  improvement  in  the  art  of  flint 
chipping,  produced,  apparently,  by  continued  experiment 
and  practice,  the  result  of  which  must  have  been  commu- 
nicated or  transmitted  from  father  to  son,  from  teacher 
to  student,  from  master  to  apprentice,  until  the  ideal  flint 
chipping  was  attained  in  the  Solutreen  leaf-shaped  blades. 

From  chipped  stone  to  polished  stone  does  not  seem  so 
great  a  change,  yet  between  the  paleolithic  and  the  neo- 
lithic period  is  a  wide,  unbridged  gap.  The  wild,  hairy 
savage  of  Paleolithic  times,  with  a  marked  difference 
€ven  in  shape  of  skull,  was  a  man  with  an  ideal,  with  a 
sense  of  beauty,  with  a  desire  not  only  to  make  those 
things  which  he  knew  he  needed,  but  even  to  decorate 
them.  From  the  rude  flint  flake  to  the  carving  on  the 
reindeer  horn  (to  be  dealt  with  in  Prehistoric  Art)  is  a 
long  step,  yet  this  step  paleolithic  man  took,  and  his 
progress  can  be  traced  along  every  inch  of  the  way. 

But  Neolithic  Man  was  a  widely  different  being.  True, 
he  followed  the  use  of  the  flint  implement,  but  he  carried 
it  to  a  higher  perfection.  He  adopted  a  local  habitation 
and  a  permanent  place  of  residence,  he  became  an  agri- 
culturist as  well  as  a  hunter  and  fisher,  and  he  buried, 
his  dead  as  though  expectant  of  a  life  to  come.  He  built 
houses  and  erected  wonderful  megalithic  monuments,  and 
at  the  last  discovered  the  art  of  smelting  metals,  and  with 
Bronze  weapons  £nd  ornaments  ushered  in  the  Age  of 
Iron. 


76 


ANTHROPOLOGY 


The  great  characterization  of  the  Neolithic  period  is 
the  wonderful  change  in  ornamentation,  the  drawings  of 
the  later  paleolithic  period  giving  place  to  mere  geomet- 
rical designs,  and  the  polishing  of  the  flints  after  they 


AMERICAN  NEOLITHIC  FLINT  SPEAR  AND  ARROW  HEADS 


had  been  chipped,  and  the  greater  skill  and  marked  care 
shown. 

After  the  flint  flakes,  used  for  many  purposes,  princi- 
pally as  knives,  perhaps  the  next  in  importance  are  the 
axes  or  celts.  There  are  many  forms  of  these  celts  and 


PREHISTORIC   ARCHEOLOGY  77 

these  flakes,  which  have  been  called  chisels,  scrapers,  axes, 
adzes,  and  so  forth,  but  the  next  true  departure  is  the 
spear-head. 

These  spear-heads  are  often  of  great  delicacy  of  make, 
so  fine,  indeed,  that  they  have  not  been  duplicated  by  any 
modern  attempts.  The  larger  scrapers  can  be  easily  made, 
but  the  manual  dexterity  required  for  the  making  of  a 
long,  thin,  evenly  beveled  spear-head,  and  the  time  and 
patience  demanded,  are  not  to  be  found  to-day.  As  has 
been  wisely  said,  let  any  one  who  does  not  appreciate  the 
value  of  these  flint  implements  in  determining  the  loca- 
tion of  Man  try  and  make  one  of  them,  and  he  will  find 
it  to  be  a  task  of  considerable  difficulty. 

Of  even  more  interest  are  the  megalithic  monuments  of 
prehistoric  man.  In  every  country  that  has  been  in  any 
sense  investigated,  the  remnants  of  strange  constructions 
of  prehistoric  times  remain.  Whether  it  be  the  circle  at 
Stonehenge,  or  the  mounds  of  Ohio,  whether  it  be  the 
monuments  in  the  desert  near  Mount  Sinai  or  the  huge 
stones  of  Peru,  whether  it  be  the  pyramids  of  Mexico  or 
of  Egypt,  the  dolmens  of  Scotland  or  the  menhirs  of  Ire- 
land, everywhere  they  are  encountered. 

England  is  full  of  them  and  the  riches  of  the  American 
prehistoric  period  are  only  barely  touched.  "In  our  own 
island,"  says  Sir  John  Lubbock,  "the  smaller  tumuli  may 
be  seen  on  every  down;  in  the  Orkneys  alone  it  is  esti- 
mated that  2,000  still  remain.  On  the  Wiltshire  Downs 
there  are  over  1,000,  in  France  there  are  4,000  dolmens, 
i, 600  menhirs,  and  450  stone  circles;  in  Denmark  they 
are  even  more  abundant;  they  are  found  all  over  Europe, 
from  the  shores  of  the  Atlantic  to  the  Ural  Moun- 
tains; in  Asia  they  are  scattered  over  the  great  steppes 
from  the  borders  of  Russia  to  the  Pacific  Ocean,  and  from 
the  plains  of  Siberia  to  those  of  Hindostan;  the  entire 
plain  of  Jelala^ad  being  literally  covered  with  tumuli  and 
monuments.  In  America  we  are  told  that  they  are  mini- 


78  ANTHROPOLOGY 

bered  by  thousands  and  tens  of  thousands;  nor  are  they 
wanting  in  Africa." 

The  stone  circle  is  usually  a  ring  of  upright  stone  sur- 
rounding a  mound.    Often,  however,  it  is  on  a  level  piece 


Fig.  23 — DOLMENS  FROM  EUROPE  AND  ASIA 

Showing  similarity   of   structure   the   world   over.     Upper   stones 
from  Kent,  England;  lower,  from  Dekkan,  India. 

of  ground  and  has  an  avenue  of  menhirs  leading  up  to  it. 
The  most  famous  of  them  all  is  Stonehenge  in  England. 
There  were  thirty  rudely  hewn  pillars  from  four  to  eight 


< 
a 
j 
u 

OS 

CJ 

2 

OS 

o 

w 


PREHISTORIC   ARCHEOLOGY  79 

feet  wide,  two  to  four  feet  thick,  and  sixteen  feet 
high  above  the  ground,  and  about  three  or  four  feet  apart, 
forming  a  circle  a  hundred  feet  in  diameter.  Each  of 
these  pillars  had  on  its  top  two  tenons  which  rested  in 
mortice  holes  cut  in  a  stone  architrave  connecting  each 
pair  of  pillars.  Most  of  the  posts  and  architraves  have 
fallen  to  the  ground,  but  enough  remain  to  show  clearly 
the  size  and  pattern  of  the  structure.  An  inner  circle 
of  stones  had  ten  posts  in  five  pairs,  each  pair  being  about 
ten  feet  from  the  one  on  either  side.  The  material  of 
these  posts  and  architraves  is  sandstone  found  in  the 
vicinity;  but  inside  of  the  second  circle  there  is  a  third 
small  circle  with  posts  of  a  blue  igneous  rock,  which  is 
supposed  to  have  been  brought  from  Ireland.  The  largest 
of  these  is  seven  feet  long,  two  feet  wide  and  a  foot 
thick.  A  large  flat  stone  in  the  center  of  the  circle  is  sup- 
posed to  have  served  as  an  altar. 

It  is  an  inexpressible  pity  that  one  of  the  finest  mega- 
lithic  monuments  in  the  world  should  have  been  despoiled. 
Of  the  great  temple  at  Avebury,  in  Wiltshire,  England, 
it  has  been  said  by  one  of  its  admirers  that  "it  did  as 
much  exceed  Stonehenge,  as  a  cathedral  a  parish  church." 
Once  650  great  stones,  forming  a  vast  circle  around  an 
artificial  hill,  and  led  up  to  by  two  avenues  of  menhirs 
half  a  mile  long,  stood  upon  the  plain,  but  the  little  village 
of  Avebury  has  been  built  upon  and  of  the  hill,  the  great 
megaliths  have  been  broken  up  for  building  stone,  and  of 
the  great  ruin,  only  twenty  stones  are  still  standing. 

Great  as  are  the  works  of  prehistoric  man  in  Britannia, 
Gaul  and  Mauritania,  they  are  rivaled  by  those  of  pre- 
historic man  in  the  New  World.  "South  of  the  barbaric 
mound-builders  of  the  Mississippi  basin,"  says  A.  H. 
Keane  in  his  'Ethnology,'  "follow  in  almost  unbroken  suc- 
cession the  Casas  Grandes  of  the  Pueblo  Indians,  New 
Mexico  and  Arizona ;  the  truncated  pyramids  and  other 
remains  of  the  Toltecs  and  their  Nahua  successors  on 
the  Anahuac  Tableland;  the  palace  of  Mitla,  South  Mex- 


8o 


ANTHROPOLOGY 


ico,  of  classic  beauty;  the  elaborately  ornamented  tem- 
ples, palaces,  convents,  raised  by  the  Mayas  of  Palenque, 
Uxmal,  Chichen-Itza  and  other  cities  of  Yucatan;  the 
great  temples  of  the  sun,  the  causeways,  aqueducts  and 
terraced  slopes  of  the  Peruvian  Quichuas.  Some  of  these 


Fig.  24 — MENHIR  IN  BRITTANY,  FRANCE,  36%  FEET  HIGH 

are  prehistoric,  while  others  reach  well  into  the  historic 
period.  But  none  can  compare  in  magnitude  and  exquisite 
finish  with  the  stupendous  megalithic  edifices  of  doubtful 
origin,  which  stand  in  an  almost  uninhabitable  region  near 
the  southern  shores  of  Lake  Titicaca  on  the  Bolivian 
plateau,  nearly  13,000  feet  above  sea-level. 


PREHISTORIC   ARCHEOLOGY  81 

• 

Altho  often  visited  and  partly   described,   full  justice 

has  only  quite  recently  been  done  to  these  astounding 
ruins  of  Tiahuanaco  by  Stiibel  and  Uhle,  who  have  de- 
voted a  sumptuous  volume  to  their  description  and  illus- 
tration. The  monuments,  which  cover  a  large  area  be- 
tween the  lake  and  Pumapunga,  tho  chiefly  centered  about 
the  Ak-Kapana  hill,  here  shown  to  be  a  natural  forma-* 
tion,  not  an  artificial  mound,  are  of  an  absolutely  unique 
character,  despite  certain  general  resemblances  to  the  neo- 
lithic structures  of  the  eastern  hemisphere.  As  shown  by 
the  numerous  highly  polished  slabs  and  blocks  lying  flat 
on  the  ground,  as  if  ready  for  the  mason,  it  is  evident  that 
all  formed  part  of  a  general  design  on  a  scale  rivaling 
that  of  the  largest  Egyptian  temples,  but  never  completed, 
the  works  having  apparently  been  interrupted  by  the  Inca 
conquerors.  They  must  have  been  in  progress  for  some 
generations  before  that  time,  for  the  blocks,  some  weighing 
from  100  to  150  tons,  had  been  conveyed  with  primitive 
appliances  from  distances  of  many  miles  over  rugged 
ground,  up  steep  inclines,  and  in  some  cases  across  several 
inlets  of  Lake  Titicaca. 

It  is  notable  that  certain  of  the  stones,  like  those  of 
Stonehenge,  have  shoulders  for  the  reception  of  horizontal 
connecting  beams,  but  far  better  dressed  arid  mortised. 
Others  form  doorways  hewn  in  a  single  piece,  one  of  which 
at  Ak-Kapana  is  the  crowning  triumph  of  the  primitive 
American  architecture.  This  marvelous  monolith,  weigh- 
ing over  twelve  tons,  is  richly  carved  on  one  face  with 
symbolic  devices  and  the  image  of  Viracocha,  tutelar  deity 
of  the  Bolivian  Aymaras,  overthrown  by  the  Quichua  wor- 
shipers of  the  rival  Peruvian  sun-god.  Nor  can  mention 
be  omitted  of  the  stupendous  earth-works  of  the  Mound- 
Builders,  whose  very  origin  is  so  obscure.  Widespread  as 
are  megalithic  monuments  in  the  Old  World,  these  mounds 
are  even  more  numerous  in  the  New.  The  number  of  them 
catalogued  runs  into  hundreds  of  thousands,  and  they  are 
found  as  forts,  as  temples,  as  observation  points;  in  the 


ANTHROPOLOGY 


forms  of  animals,  birds  and  human  figures;  of  regular 
geometrical  forms  and  of  shapes  the  very  purpose  of  which 
is  unknown;  of  several  different  styles  of  construction, 


Fig.   25 — GREAT   SERPENT  MOUND  OF   OHIO 


Earthwork  700  ft.  long;  1,000  ft.  extended;  base,  30  ft.  broad; 
height,  5  ft.,  tapering;  oval,  160x80  ft.;  on  edge  of  sheer 
cliff  150  ft.  above  creek. 

presuming  the  existence  of  an  extensive  civilization  over 
the  entire  United  States. 

"Lacustrine  or  marine  settlements  form  an  interesting 


;  PREHISTORIC   ARCHEOLOGY  83 

feature  in  the  evolution  of  human  progress,"  points  out 
A.  H.  Keane  in  his  'Ethnology/  "their  development  being 
intimately  dependent  on  the  local  conditions  at  certain 
stages  of  culture.  Communities  seated  by  the  shores  of 
lakes  or  shallow  inland  seas  possess  obvious  advantages 
over  tribes  confined  to  the  woodlands  or  the  plains.  They 
draw  their  supplies  both  from  land  and  water,  and  to  their 
other  resources  are  added  navigation  followed  by  barter 
and  piracy.  But  on  the  other  hand,  the  wealth  thus  rap- 
idly accumulated  exposes  them  to  the  attacks  of  predatory 
hordes,  to  guard  against  which  they  take  refuge  in  their 
boats.  They  are  thus  gradually  transformed  to  a  floating 
population,  which  soon  learns  to  adapt  itself  to  the  new 
environment  by  erecting  dwellings  on  platforms  resting  on 
piles  driven  into  the  mud  or  sands  of  a  shelving  beach. 
Then,  when  peaceful  days  and  orderly  government  take  the 
place  of  lawless  habits,  a  return  is  made  to  terra  firma,  and 
the  abandoned  lacustrine  dwellings  soon  disappear;  but 
the  sites  remain  the  safe  depositories  of  the  multifarious 
objects  of  human  industry  which  have  accumulated  be- 
neath the  shallow  waters  during  their  occupation." 

Such  is  the  history,  either  completed  or  still  in  progress, 
of  the  numerous  floating  habitations  which  are  found  in 
every  part  of  the  world  from  the  New  Guinea  coastlands 
and  the  estuaries  of  the  Borneo  rivers  to  Helvetia  and  the 
British  Isles,  and  beyond  the  Atlantic  to  the  aquatic  set- 
tlements of  the  Maracaibo  Sea,  to  which  the  surrounding 
region  owes  its  present  name  of  Venezuela,  "Little  Ven- 
ice." Such  especially  is  the  history  of  the  Swiss  lake- 
dwellings,  the  recent  exploration  of  which  has  shown  them 
to  be  one  of  the  richest  storehouses  of  neolithic  and  pre- 
historic industries.  Antiquaries  have  already  explored 
over  two  hundred  of  such  stations,  some  of  which  were 
occupied  again  and  again,  like  Hissarlik  (Troy),  Lachish, 
and  those  other  eastern  cities,  where  the  vestiges  of  sev- 
eral distinct  civilizations  are  found  superimposed  one  on 
the  other. 


84  ANTHROPOLOGY 


4 


At  Robenhausen,  south  side  of  Lake  Pfaffikon,  three 
such  prehistoric  occupations  have  been  disclosed,  each 
destroyed  before  the  next  began,  as  shown  by  the  three 
sets  of  piles  (100,000  altogether),  each  projecting  from 
3  to  5  feet  higher  than  the  one  below.  So  also  at  Morges, 
on  the  north  side  of  Lake  Geneva,  there  were  three  dif- 
ferent stations,  here,  however,  not  superimposed,  but 
standing  in  close  proximity  within  a  space  of  about  a 
third  of  a  mile.  Nevertheless,  they  were  not  inhabited 
simultaneously,  but  successively,  as  shown  by  their  relics, 
all  stone  in  the  earliest,  stone  and  rude  bronze  hatchets 
in  the  next,  bronze  alone  and  very  fine  bronze  in  the  last, 
the  great  prehistoric  city  of  Morges.  Even  the  present 
Morges  appears  to  be  some  1,200  or  1,500  years  old;  yet 
it  never  had  any  record  or  memory  of  its  predecessor  till 
its  existence  was  revealed  in  1854  by  the  subsidence  of 
the  lake,  due  to  an  exceptionally  long  drought. 

The  Bronze  Age  is  one  of  the  most  unsettled  periods  in 
Archeology.  It  is  clear,  of  course,  that  it  follows  the  Neo- 
lithic Age  in  general  and  that  it  preceded  the  Age  of  Iron, 
but  it  by  no  means  is  clear  that  it  was  not  in  many  cases 
synchronous  with  the  later  Neolithic.  Every  find  of  bronze 
as  weapons  and  implements  has  been  made  in  connection 
with  Neolithic  remains  and  there  is  no  instance  of  a  long 
continuance  of  the  use  of  bronze  after  the  knowledge  of 
iron.  But  the  use  of  bronze  as  ornamental  purposes  con- 
tinued well  on  into  historic  times,  and  indeed  it  cannot  be 
said  to  be  entirely  abolished  to-day. 

"Many  objects  of  wrought  copper  have  been  found  in 
America,"  says  Thos.  Wilson.  "The  Lake  Superior  copper 
mines  in  the  States  of  Wisconsin  and  Michigan  appear  to 
have  been  the  center  of  manufacture,  from  which  the  dis- 
tribution took  place,  and  thence  the  manufactured  imple- 
ments spread,  in  gradually  decreasing  numbers,  in  every 
direction  throughout  the  present  territory  of  the  eastern 
United  States.  The  modes  of  treating  copper,  whether  by 
smelting,  melting,  casting  or  hammering,  and  if  any  or  all 


I 


PREHISTORIC  ARCHEOLOGY 


of  these,  what  amount  of  heating  or  melting  was  done,  has 
never  been  fully  investigated  nor  have  they  been  satisfac- 
torily determined.  Some  of  the  objects  were  certainly  of 
virgin  copper  hammered  cold,  and  they  were  thus  made 


Fig.  26 — HUMAN  FIGURE  OF  REPOUSSE  COPPER  MADE  BY  GEORGIA 
MOUND-BUILDERS  (U.  S.  N.  M.) 

into  bracelets,  rings,  and  similar  objects  of  personal  adorn- 
ment, and  also  into  axes,  knives,  and  spearheads.  These 
copper  weapons  and  ornaments  continued  to  be  used  con- 


86  ANTHROPOLOGY 

temporaneously  with  cutting  implements  of  stone  and  of 
ornaments  of  shell  and  bone. 

"Among  the  many  mysteries  of  prehistoric  archeology 
growing  out  of  mound  excavation  in  the  United  States, 
wherein  things  strange  and  wonderful  but  of  undoubted 
genuineness  and  antiquity  are  found,  none  are  more  unex- 
plained than  the  thin  sheets  of  copper  wrought  by  repousse 
work  into  curious  and  unknown  devices  found  in  mounds 
and  earthworks  in  widely  separated  regions  of  the  country. 
The  principal  specimens  come  from  the  Tumlin  mounds 
on  the  Etowah  River,  near  Cartersville,  Ga.,  but  Ohio  and 
Illinois  mounds  also  have  furnished  examples." 

By  such  steps  as  these,  therefore,  can  be  roughly  traced 
the  development  of  Man  from  his  earliest  ancestor  as  Man 
down  to  the  Historic  period.  How  many  years  elapsed 
between  the  period  of  'Homo  Primigenius*  and  the  first 
flint-flake  there  is  no  means  of  determining,  neither  can 
it  be  said  whether  it  was  in  hundreds,  thousands  or  tens 
of  thousands  of  years.  It  is  now  thought  improbable, 
however,  that  Man's  ancestor  in  the  Tertiary  Epoch  could 
rightly  be  called  Man,  but  it  is  obvious  that  the  date  of 
the  beginning  of  the  Quaternary  would  be  extremely  diffi- 
cult to  estimate,  even  approximately. 

His  life  was  largely  influenced  by  his  weapons  and  his 
tools,  and  they  again  reflect  to  his  successor  the  life  he  led. 
By  their  means,  therefore,  it  becomes  possible  in  a  meas- 
ure to  reconstruct  the  life  of  Primitive  Man  and  to  shadow 
forth  the  development  of  that  more  subtle  force  called  cul- 
ture. Anthropology  has  detailed  what  Man  is  and  the 
conditions  of  his  physical  frame,  Ethnology  has  set  forth 
his  racial  division  and  specific  unity,  Ethnography  has 
pointed  out  his  distribution,  and  Archeology  has  collated 
and  classified  the  evidences  of  his  early  being;  it  remains 
therefore  to  bring  all  these  together  under  a  consideration 
of  the  development  of  culture,  that  perhaps  a  vague  outline 
of  the  philosophy  of  primeval  history  may  come  into  view. 


CHAPTER  VI 

THE  DEVELOPMENT  OF  CULTURE 

To  THE  development  of  Man  as  an  individual  and  as  a 
race  must  be  added  his  advance  as  a  producer  of  that  which 
is  called  Civilization.  For  it  is  the  especial  prerogative  of 
Man  to  be  the  ruler  of  his  environment,  not  the  slave  of  it, 
and  whereas  the  effect  of  the  animal  upon  the  environment 
is  always  purely  unconscious,  the  influence  of  Man  is  pur- 
poseful. He  is  not  content  with  taking  Nature  as  he  finds 
her,  but  has  the  audacity  and  the  power  to  utilize  her 
forces  and  even  to  divert  them. 

It  is  of  course  abundantly  clear  that  such  a  daring  flight 
of  thought  never  occurred  as  such  to  Primitive  Man,  nay 
rather,  that  he  conceived  Nature  as  being  a  supernatural 
or  a  group  of  supernaturals ;  but  none  the  less,  even  at  such 
a  time,  he  conceived  the  idea  of  influencing  those  super- 
natural personified  forces  by  worship,  sacrifice  and  so 
forth.  It  is  one  of  the  essential  characteristics  of  Man 
that  he  is  conscious  of  his  power  and  seems  inwardly  to 
believe  with  the  Ancient  Pistol,  "The  world  is  mine 
oyster,  which  I  with  mine  sword  will  open." 

That  the  human  embryo  passes  through  the  various 
stages  of  the  mammalian  stem  prior  to  the  branching  forth 
of  Man  has  been  abundantly  shown,  and  indeed  now  is  not 
to  be  questioned,  and  it  is  equally  true  that  the  develop- 
ment of  the  mind  of  the  child  during  childhood  follows 
closely  upon  the  scale  of  mental  faculties  possessed  by  the 
lower  animals,  paralleling  them  in  nearly  all  details.  The 

87 


88  ANTHROPOLOGY 

emotional  faculties  of  the  child,  moreover,  can  scarcely  be 
distinguished  from  those  belonging  to  the  simpler  orders 
of  animal  life. 

If  the  history  of  the  individual  be  used  as  a  comparison 
for  the  history  of  Mankind,  precisely  the  same  condition 
will  be  seen  to  appear.  In  the  earliest  times  of  Man  his 
mental  condition  was  not  different  from  that  of  the  crea- 
tures around  him,  but  he  possessed  the  capacity  for  greater 
progress  and  higher  advancement  than  they.  The  very 
flint  instruments  that  have  been  considered  tell  the  same 
story,  passing  from  the  rudest  flakes  of  the  Chelleen  divi- 
sion of  the  Paleolithic  period  to  the  most  polished  speci- 
mens of  the  Neolithic  Age  just  ere  bronze  changed  the 
conditions  of  Man  and  led  to  the  way  to  a  further  civiliza- 
tion. Likewise  in  shelters,  from  the  rude  sticks  covered 
with  the  skins  of  animals  and  heaps  of  rough  piled  stones 
to  the  wonders  of  the  Parthenon  is  not  one  mighty  stride 
born  from  an  inspiration,  but  a  long,  slow,  careful  process, 
each  improvement  building  upon  the  last.  And  whether 
such  a  comparison  be  carried  out  into  the  mind  of  thought, 
from  fetichism  to  the  Brahma  of  the  Vedas  and  the  God 
of  Isaiah,  from  guttural  stammerings  to  the  oratory  of 
Demosthenes  and  the  literature  of  Goethe,  from  the  use  of 
the  wife  as  a  beast  of  burden  to  the  modern  railroad,  all 
alike  tell  the  same  story  of  progress  starting  from  the 
humblest  beginnings,  the  same  triumphal  march  of  evo- 
lution. 

It  seems  wise  to  point  out  at  this  place  that  the  Develop- 
ment of  Culture  is  not  to  be  regarded  as  the  steps  that 
have  been  taken  from  imperfection  to  perfection,  but  as  the 
advance  from  imperfection  to  a  slightly  less  imperfection. 
The  human  mind  at  present  is  not  formed,  but  only  form- 
ing, and  there  are  heights  illimitable  yet  to  be  climbed.  By 
slow  and  dubious  steps,  groping  wearily  in  the  dark,  the 
ancestors  whose  lives  are  learned  only  from  their  flint 
remains,  climbed  to  simple  consciousness.  Self-conscious- 
ness— a  far  higher  concept — was  not  reached  probably  for 


THE  DEVELOPMENT  OF  CULTURE    89 

thousands  of  years  later,  and  unconscious  self-conscious- 
ness, paradox  tho  it  seem,  is  one  of  the  avenues  along 
which  it  is  seen  that  the  mind  of  Man  is  tending. 

But  it  would  be  a  heinous  mistake  to  suppose  that 
"surely  we  are  the  people  and  wisdom  will  die  with  us," 
for  it  is  as  affirmed  as  any  scientific  fact  can  be  that  Evo- 
lution is  an  invincible  force  not  to  be  stopped  by  any 
human  agency.  It  has  always  gone  on,  it  still  is  going  on, 
and  so  far  as  can  presently  be  seen,  it  always  will  go  on. 
Some  of  the  old  mental  faculties  are  dying  out  and  others 
taking  their  place,  not  with  any  degree  of  uniformity,  but 
in  such  wise  that  looking  back  over  a  vista  of  centuries  it 
can  be  seen  that  there  has  been  a  distinct  advance.  There 
have  been  losses  also,  but  the  general  direction  has  been 
upward.  Whether  the  present  gropings  for  relations  to  a 
super-sensual  sphere,  such  as  telepathy  and  clairvoyance, 
are  vague  shadowings  of  future  lines  of  development  or 
merely  temporary  phases  of  thought  is  yet  to  be  seen,  but 
it  is  certain  that  they  cannot  be  overlooked  in  any  consid- 
eration of  the  probable  development  of  the  future. 

A  long  distance  has  been  traversed,  how  great  a  dis- 
tance is  best  seen  by  comparing  the  percept  of  the  savage 
and  probably  of  primitive  man  with  the  concept  of  the  best 
developed  mind.  Suppose  the  word  'star'  be  taken  as  a 
case  in  point.  The  recognition  of  one  particular  star  is  a 
simple  idea  or  percept,  the  recognition  of  a  number  of 
stars,  or  of  bright,  twinkling  objects  resembling  the  shin- 
ing of  stars,  is  a  complex  idea  or  recept.  So  far  the  mind 
of  the  higher  brutes  keeps  pace  with  the  developing  mind 
of  man.  But  the  next  step  carries  us  beyond  the  mental 
powers  both  of  infants  and  of  animals;  neither  can  con- 
ceive the  idea  of  a  star  as  present  to  the  mind  of  an 
astronomer.  This  is  an  abstract  idea  or  concept,  and  is 
unattainable  except  through  the  medium  of  articulate  lan- 
guage. Where  the  child  sees  a  twinkling  spark  the  as- 
tronomer is  conscious  of  a  flaming  sun;  where,  until 
lately,  men  recognised  the  symbol  of  unchangeableness, 


90  ANTHROPOLOGY 

the  astronomer  knows  he  beholds  stupendous  worlds  rush- 
ing through  space  at  unimaginable  speed;  where  the 
Hebrew  seer  beheld  "lesser  lights"  stuck  in  a  solid  firma- 
ment solely  for  the  service  of  man,  the  astronomer  knows 
that  his  eye  beholds  objects  at  a  distance  of  millions  upon 
millions  of  miles,  objects  whose  grandeur  throws  our 
whole  solar  system  into  insignificance.  An  abstract  idea 
is  in  itself  capable  of  containing  a  volume  of  knowledge; 
its  capacities  have  hardly  any  limits  but  that  of  the  mind 
itself. 

Thus  upon  the  character  of  the  traditional  material  lies 
the  chief  line  of  difference  in  the  results  of  thought. 
Herein  lies  the  immense  importance  of  folklore.  Herein 
also  lies  particularly  the  enormous  influence  of  current 
philosophic  opinion  upon  the  masses  of  the  people,  and 
herein  lies  the  influence  of  the  dominant  scientific  theory 
upon  the  character  of  scientific  work.  It  would  be  in  vain 
to  try  to  understand  the  development  of  modern  science 
without  an  intelligent  understanding  of  modern  philoso- 
phy; it  would  be  in  vain  to  try  to  understand  the  history 
of  medieval  science  without  an  intelligent  knowledge  of 
medieval  theology ;  and  so  it  is  in  vain  to  try  to  understand 
primitive  science  without  an  intelligent  knowledge  of 
primitive  mythology.  Mythology,  theology  and  philosophy 
are  different  terms  for  the  same  influences  which  shape 
the  current  of  human  thought  and  which  determine  the 
character  of  the  attempts  of  man  to  explain  the  phe- 
nomena of  Nature. 

The  influence  of  traditional  material  upon  the  life  of 
man  is  not  restricted  to  his  thoughts,  but  manifests  itself 
no  less  in  his  activities.  The  comparison  between  civilized 
man  and  primitive  man  in  this  respect  is  even  more  in- 
structive than  in  the  preceding  case.  A  comparison  be- 
tween the  modes  of  life  of  different  nations,  and  particu- 
larly of  civilized  man  and  of  primitive  man,  makes  it  clear 
that  an  enormous  number  of  actions  are  determined  en- 
tirely by  traditional  associations. 


THE  DEVELOPMENT  OF  CULTURE    91 

"When  we  consider,"  said  John  Evans  before  the  An- 
thropological Society  of  England,  "for  instance,  the  whole 
range  of  our  daily  life,  we  notice  how  strictly  we  are  de- 
pendent upon  tradition  that  cannot  be  accounted  for  by 
any  logical  reasoning.  We  eat  our  three  meals  every  day, 
and  feel  unhappy  if  we  have  to  forego  one  of  them.  There 
is  no  physiological  reason  which  demands  three  meals  a 
day,  and  we  find  that  many  people  are  satisfied  with  two 
meals,  while  others  enjoy  four  or  even  more.  The  range 
of  animals  and  plants  which  we  utilize  for  food  is  limited, 
and  we  have  a  decided  aversion  against  eating  dogs,  or 
horses,  or  cats.  There  is  certainly  no  objective  reason  for 
such  aversion,  since  a  great  many  people  consider  dogs 
and  horses  as  dainties. 

"When  we  consider  fashions,  the  same  becomes  still 
more  apparent.  To  appear  in  the  fashions  of  our  fore- 
fathers of  two  centuries  ago  would  be  entirely  out  of  the 
question  and  would  expose  one  to  ridicule.  The  whole 
range  of  actions  that  are  considered  as  proper  and  im- 
proper cannot  be  explained  by  any  logical  reason,  but  are 
almost  all  entirely  due  to  custom;  that  is  to  say,  they  are 
purely  traditional.  This  is  even  true  of  customs  which 
excite  strong  emotions,  as,  for  instance,  those  produced 
by  infractions  of  modesty." 

It  will  be  obvious  to  the  reader  that  the  modern  view- 
point of  Culture  is  that  it  has  developed,  not  that  it  is  the 
remains  of  something  still  higher  which  has  been  grad- 
ually lost.  The  religious  dogma  of  the  Fall  of  Man  under 
medieval  theology  came  to  be  applied  to  more  than  the 
moral  aspect,  with  the  sad  result  that  a  conception  arose 
which  depicted  Adam  and  Eve  as  possessing  all  knowl- 
edge, and  their  descendants  as  continually  falling  away 
therefrom.  Even  in  the  nineteenth  century,  in  his  "Soirees 
de  St.  Petersburg/  Count  Joseph  de  Maistre  wrote:  "We 
separate  ourselves  always  from  that  banal  hypothesis  that 
Man  had  gradually  elevated  himself  from  a  condition  of 
barbarism  to  an  understanding  of  science  and  to  civili- 


92  ANTHROPOLOGY 

zation.  This  is  the  fondest  dream,  the  mother-error,  and 
as  it  is  taught  in  the  schools,  underlying  falsity  of  our  age." 
He  goes  on  to  speak  of  the  "philosophers  of  this  unhappy 
age,  who,  with  the  horrible  perversity  that  we  have  seen 
in  them,  persist  in  their  errors  in  spite  of  the  warnings 
they  have  received,"  and  decline  to  follow  the  Count's 
lead  in  the  degeneration  theory. 

But  progression  in  culture,  while  universally  conceded 
at  the  present  time,  is  by  no  means  a  new  theory.  Even  the 
historian  Gibbon,  in  his  'Decline  and  Fall  of  the  Roman 
Empire/  perceived  that  by  no  other  conception  save  that 
of  progression  could  the  events  of  history  be  read  intelli- 
gently. "The  discoveries  of  ancient  and  modern  naviga- 
tors," he  said,  "and  the  domestic  history  of  tradition  of  the 
most  enlightened  nations,  represent  the  human  savage 
naked  both  in  mind  and  body,  and  destitute  of  laws,  of 
arts,  of  ideas  and  almost  of  language.  From  this  abject 
condition,  perhaps  the  primitive  and  universal  state  of 
Man,  he  has  gradually  arisen  to  command  the  animals,  to 
fertilize  the  earth,  to  traverse  the  ocean  and  to  measure 
the  heavens.  His  progress  in  the  improvement  and  exer- 
cise of  his  mental  and  corporeal  faculties  has  been  irregu- 
lar and  various.  Infinitely  slow  in  the  beginning  and  in- 
creasing by  degrees  with  redoubled  velocity,  ages  of  la- 
borious ascent  have  been  followed  by  a  moment  of  rapid 
downfall;  and  the  several  climates  of  the  globe  have  felt 
the  vicissitudes  of  light  and  darkness. 

"Yet  the  experience  of  four  thousand  years  should  en- 
large our  hopes  and  diminish  our  apprehensions;  we  can- 
not determine  to  what  height  the  human  species  may  aspire 
in  their  advances  toward  perfection;  but  it  may  safely  be 
presumed  that  no  people,  unless  the  face  of  nature  is 
changed,  will  relapse  into  their  original  barbarism.  We 
may  therefore  acquiesce  in  the  pleasing  conclusion,  that 
every  age  of  the  world  has  increased,  and  still  increases, 
the  real  wealth,  the  happiness,  the  knowledge,  and  perhaps 
the  virtue  of  the  human  race." 


THE  DEVELOPMENT  OF  CULTURE    93 

That  two  such  diverse  points  of  view  should  have  had 
many  wise  supporters  leads  to  the  conclusion  that  there 
must  be  something  that  is  true  in  each.  "Of  course,"  says 
E.  B.  Tylor  in  his  'Primitive  Culture/  "the  progression 
theory  recognises  degradation,  and  the  degradation  theory 
recognises  progression  as  powerful  influences  in  the 
course  of  Culture.  Under  proper  limitations  the  princi- 
ples of  both  theories  are  conformable  to  historical  knowl- 
edge, which  shows  us,  on  the  one  hand,  that  the  state  of 
the  higher  nations  was  reached  by  progression  from  a 
lower  state,  and,  on  the  other  hand,  that  culture  gained 
by  progression  may  be  lost  by  degradation.  If  in  this 
inquiry  we  should  be  obliged  to  end  in  the  dark,  at  any 
rate  we  need  not  begin  there." 

The  famous  argument  adduced  by  Niebuhr  against  the 
progressionists  that  "no  single  example  can  be  brought 
forward  of  an  actually  savage  people  having  independently 
become  civilized,"  seems  to  possess  a  great  deal  of  strength 
until  it  is  pointed  out  that  the  obverse  of  the  same  question 
may  well  be  put  to  the  degradationists,  in  the  following 
form:  No  single  example  can  be  brought  forward  of  an 
actually  civilized  people  having  independently  become  sav- 
age. There  are  things  which  lend  themselves  'prima  facie* 
to  support,  and  others  that  do  not,  and  the  idea,  for  in- 
stance, that  a  tribe  which  had  learned  the  production  of 
fire  by  a  drill  should  willingly  go  back  to  the  more  toil- 
some method  of  rubbing  two  sticks  together  belongs  to  the 
latter  class. 

But  Sir  Charles  Lyell,  with  the  vein  of  sarcasm  he  knew 
so  well  to  use — sometimes  disastrously — deals  with  the  deg- 
radation theory  in  such  wise  as  to  settle  it  in  a  few  sen- 
tences. Speaking  of  the  progressive  nature  of  the  finds 
in  earlier  geological  deposits,  and  contrasting  the  actual 
evidence  with  the  imagined  hypothesis,  he  says,  "Instead 
of  the  rudest  pottery  or  flint  tools,  so  irregular  in  form  as 
to  cause  the  unpracticed  eye  to  doubt  whether  they  afford 
unmistakable  evidence  of  design,  should  we  not  be  finding 


94  ANTHROPOLOGY 

sculptured  forms  surpassing  in  beauty  the  masterpieces 
of  Phidias  or  Praxiteles;  lines  of  buried  railway  and  elec- 
tric telegraphs,  from  which  the  best  engineers  of  our  day 
might  gain  invaluable  hints ;  astronomical  instruments  and 
microscopes  of  more  advanced  construction  than  any 
known  in  Europe,  and  other  indications  of  perfection  in 
the  arts  and  sciences,  such  as  the  nineteenth  century  has 
not  yet  witnessed?  Still  farther  would  the  triumphs  of 
inventive  genius  be  found  to  have  been  carried,  when  the 
later  deposits,  now  assigned  to  the  ages  of  bronze  and 
iron,  were  formed.  Vainly  should  we  be  straining 
our  imagination  to  guess  the  possible  uses  and  meanings 
of  such  relics — machines,  perhaps  for  navigating  the  air 
or  exploring  the  depths  of  the  ocean,  or  for  calculating 
arithmetical  problems  beyond  the  wants  or  even  the  con- 
ceptions of 'living  mathematicians." 

It  may  be  assumed  as  proved,  therefore,  that  Culture  is 
to  be*  regarded  as  a  matter  of  development,  rather  than  as 
a  matter  of  deterioration,  and  that  all  the  study  of  Pre- 
historic and  of  Historic  Man  is  to  be  regarded  as  an  ap- 
panage of  a  study  of  Culture.  In  a  preface  to  a  work, 
'History  of  the  Mental  Growth  of  Mankind  in  Ancient 
Times/  John  S.  Hittell  has  propounded  a  series  of  ques- 
tions, the  answers  to  which  would  cover  the  whole  history 
of  the  development  of  Culture.  It  is  most  suggestive,  if 
only  to  show  the  immensity  of  the  field  the  student  of 
Culture  must  endeavor  to  cover. 

When  the  question  arises  as  to  the  divisions  in  the 
development  of  culture,  Hittell  makes  a  triple  culture  step, 
Savagism,  Barbarism  and  Civilization.  The  division  is 
arbitrary,  of  course,  and  the  nations  that  he  places  in  each 
division  will  not  secure  general  agreement,  and  it  would 
seem  perhaps  more  convenient  to  add  a  fourth,  splitting 
in  twain  his  division  of  Barbarism.  In  the  division  of 
Savagism  can  certainly  be  placed  the  entire  Negroid  Race, 
for  it  cannot  be  said  that  any  single  tribe  of  the  black  race 
— and  this  is  a  sufficiently  remarkable  fact — have  ever 


THE  DEVELOPMENT  OF  CULTURE    95 

reached  Barbarism,  much  less  Civilization.  Uncultured 
they  have  been  ever,  and  it  appears  probable  that  ignorant 
they  will  ever  remain.  Hybrids  of  negro  and  white  may 
continue  and  flourish,  nurtured  under  a  non-indigenous 
hothouse  condition  of  civilization  they  may  prosper,  but 
the  Black  Republic  and  the  Negro  Empire  of  Haiti 
answer  all  questions  as  to  the  fate  of  negroes,  after  they 
have  been  taught,  being  left  to  their  own  devices.  The 
Negroid,  living  in  Negroid  environment,  so  far  as  can  be 
found  out,  has  made  no  step  toward  true  civilization. 

There  is  probably  some  little  arrogance  in  making  a  dis- 
tinction between  types  of  Civilization  and  making  a  sep- 
arate class  of  them,  but  none  the  less  a  word  is  needed  to 
express  the  races  which  advanced  to  a  certain  point,  and 
then,  for  many  reasons,  suffered  an  arrest  of  development. 
The  Chinese,  for  example,  cannot  be  called  a  barbarous 
race,  as  Hittell  has  done,  for  their  civilization  is  equally 
well  grounded  with  the  Caucasian.  But  it  has  not  reached 
as  far,  and  it  does  not  seem  to  be  progressing,  insomuch 
that  they  are  always  cited  as  an  example  of  arrested  de- 
velopment. Of  a  far  lower  order  are  the  Nahua  and  Aztlan 
civilizations  in  America.  It  might  be  well,  therefore,  to 
class  such  nations  as  the  Chinese  under  'Arrested  Civili- 
zations' as  contrasted  with  'Progressive  Civilizations/  it 
being  understood  that  no  stigma  attaches  thereto.  The 
Archaean  White  race  also  would  come  under  this  class. 

Barbarism  is  certainly  the  condition  of  the  primitive 
American  races.  They  had  only  recently  arisen  from  the 
stone  age,  and  despite  the  wonderful  works  that  they  had 
succeeded  in  doing,  their  only  tools  were  of  bronze.  It  is 
laying  a  little  too  much  stress  on  bronze,  perhaps,  to  make 
this  the  cause  for  a  culture-division,  but  in  the  case  of 
the  American  Primitive  Races,  this  was  coupled  to  cus- 
toms purely  barbaric,  such  as  human  sacrifices  and  can- 
nibalism. 

For  example,  it  is  stated  that  "the  most  common  method 
of  sacrifice  among  the  Aztecs  was  that  the  person  was 


96  ANTHROPOLOGY 

laid  with  his  back  upon  a  convex  stone,  and  while  his  legs, 
arms  and  head  were  held  by  five  priests,  another  cut  open 
his  breast,  and  took  out  his  heart,  held  it  up  to  the  sun, 
rubbed  the  lips  of  the  idol  with  it  and  then  threw  it  into 
a  basin  which  stood  on  the  altar.  If  the  victim  was  a 
prisoner  of  war,  the  corpse  was  thrown  from  the  top  of 
the  temple  pyramid,  where  it  was  picked  up  by  the  owner, 
the  captor,  who  took  it  to  his  house  to  be  cooked  and 
eaten.  When  the  maize  began  to  sprout  a  boy  and  girl 
of  noble  blood  were  drowned;  when  it  began  to  blossom, 
four  children  were  starved  to  death  in  a  cavern."  Another 
custom  was  that  of  starting  the  new  fire  each  temple 
year  upon  the  naked  breast  of  a  slave. 

Such  a  division  would  give  Savagism,  including  the 
Negroid  Race ;  Barbarism,  comprising  the  Americ  Race ; 
Arrested  Civilization,  the  Mongoloid  and  Archaean  White ; 
and  Progressive  Civilization,  the  Caucasic. 

The  fourth  division  of  mankind,  that  of  'Progressive 
Civilization/  truly  seems  to  be  the  heritage  of  the  Cau- 
casian race,  the  home  of  the  various  branches  of  which, 
having  absorbed  aboriginal  inhabitants,  extends  from  Cey- 
lon to  Scandinavia,  and  in  whose  grasp  North  America  and 
Australia  have  fallen.  It  would  be  taken  to  include  the 
Greeks,  Romans  and  the  European  nations  generally. 
Whether  the  effect  of  Caucasian  influence  upon  the  ar- 
rested development  of  the  Mongoloid  (as  in  Japan)  will 
evoke  a  new  growth  in  that  division  of  the  race  is  not 
improbable,  and  if  so,  would  only  serve  to  show  that  Mon- 
goloid civilization  culture  is  true  progressive  civilization, 
temporarily  arrested  but  only  slumbering. 

American  civilization  is  not  less  deserving  of  study  than 
those  of  earlier  times  and  lower  rank.  Its  startling  rise 
and  its  supremacy  in  the  one  aspect  of  industrial  adapta- 
bility are  characters  of  the  most  profound  interest.  The 
causes  that  have  operated  within  three  centuries  to  bring 
together  the  nuclei  in  Virginia,  in  Maryland,  in  New  Am- 
sterdam and  in  New  England,  to  add  to  these  elements  the 


THE    DEVELOPMENT   OF   CULTURE        97, 

most  diverse  possible,  and  therefrom  to  educe  a  civiliza- 
tion with  a  national  ideal  different  from  any  of  those  that 
have  gone  before,  is  a  matter  for  very  careful  study. 

It  would  almost  seem  as  though  the  culture  of  the 
United  States  was  not  so  much  slightly  changing  the  old 
channels,  as  cutting  new  ones.  The  occultism  and  mys- 
tery of  the  east  is  hetero-mundane  to  the  purely  scientific 
attitude  of  the  ideal  European  mind;  but  the  endeavor  on 
the  part  of  the  American  to  transliterate  pure  into  allied 
Science  and  intellectualism  into  utilitarianism  is  again 
more  different  still.  It  is  not  difference  of  degree,  but 
a  difference  of  kind,  and  those  who  are  needfully  observing 
the  culture-development  of  America  are  beginning  to  see 
that  the  New  World  will,  when  she  reaches  a  full  strength, 
give  to  Man  a  Culture  different  from  any  that  has  gone 
before. 

That  this  is  not  yet  realized  perhaps  is  due  to  the  fact 
that  the  prophets  of  that  spirit  have  not  yet  appeared ;  that 
the  poets,  artists,  architects,  sculptors,  dramatists  and 
scholars,  are  still  in  the  lotos-dream  of  European  ascen- 
dency. The  engineer,  the  mechanician,  the  inventor,  the 
industrial  monarch,  the  railroad  king,  and  the  Great  Khan 
of  trade,  are  more  in  keeping  with  the  growing  American 
spirit,  and  hence  arises  the  anomaly  of  those  men's  names 
being  upon  people's  lips  who  seem  to  have  naught  else  but 
wealth  to  recommend  them  as  the  cause  of  fame. 

It  will  appear  in  course  of  time,  however,  that  the  pub- 
lic sense  is  none  so  trifling  a  thing,  and  that  these  men 
stand  for  an  ideal  yet  barely  grasped  at,  hardly  felt,  where- 
in utilitarianism  will  arise  into  a  mighty  force,  and  the 
spirit  that  shall  move  men's  souls  will  be  that  of  prizing 
usefulness  to  their  fellowmen  more  than  their  favor.  To 
desire  to  grow  rich  for  the  sake  of  selfish  luxury  is  an  ig- 
noble seeking,  and  it  seems  unjust  to  American  culture  to 
suppose  that  this  is  the  cause  of  the  money-making  spirit ; 
it  would  seem  juster  and  not  a  whit  less  true  to  believe 
that  the  strife  for  the  acquisition  of  wealth  is  due  to  an 


98  ANTHROPOLOGY 

inherent  sense  that  the  masters  of  the  world  in  the  future 
will  be  Americans  and  that  the  resources  of  the  world 
should  be  under  their  hands. 

The  old  Chaldean  culture  lent  a  magic  spell  over  the 
mind  of  Man,  yet  made  him  conscious  of  his  Destiny;  the 
Grecian  culture  founded  itself  upon  estheticism,  but 
taught  him  Beauty;  the  Roman  culture  was  built  up  by 
the  sword,  yet  Justice  and  Law  became  its  heritage;  Latin 
Christianity  called  in  the  aid  of  superstition,  yet  from  it 
Man  learned  Reverence;  northern  Christianity  was  con- 
stantly riven  asunder  in  theological  bickerings,  yet  did  the 
race  learn  Religious  Liberty;  France  passed  through  the 
scenes  of  the  Terror,  to  teach  the  Kinship  of  Classes ;  Eng- 
land was  forced  to  never-ceasing  vigilance  in  the  waters 
around  her  island  home,  that  Dignity  and  the  power  of 
National  Protection  might  be  made  known;  and  America, 
amid  her  throes  and  struggles,  stands  as  the  Good  Samari- 
tan to  the  world's  wretched  ones,  tending  them,  guarding 
them,  teaching  them  to  be  worthy  of  the  land  of  their 
adoption.  America  is  yet  a  child,  but  men  are  beginning 
to  see  that  her  ideals  are  not  borrowed  and  that  her  Cul- 
ture is  her  own. 


MEDICINE 


THEODORE   H.    ALLEN,    M.D. 


MEDICINE 

CHAPTER  i 

THE  ANCIFNTG  - 

THE  development  of  anatomy  and  physiology,  since  the 
earliest  days  of  mankind,  is  so  closely  interwoven  with 
the  history  of  medicine  and  philosophy  that  no  considera- 
tion of  the  medical  arts  is  possible  without  some  realiza- 
tion of  the  strange  complications  of  thought  at  tkat  early 
time.  It  is  Science  now,  but  it  was  Mystery  then.  Mys- 
tery overhung  the  thinkers  of  antiquity,  and  nowhere  did 
this  element  of  magic  and  of  wonder  have  a  stronger  hold 
than  in  the  strange  humors  of  disease,  for  which  they 
could  find  none  other  explanation  than  that  they  were 
punishments  inflicted  by  gods  or  demons. 

With  this  well-nigh  universal  conception  of  the  causes 
of  disease,  it  followed  naturally  that  healing  could  only 
attend  the  propitiation  of  the  gods  by  suitable  sacrifices, 
prayers  and  penances,  and  the  offices  of  priest  and  physi- 
cian were  unified.  But  instead  of  this  aggrandizing  the 
doctor's  importance,  public  opinion  veered.  Inasmuch  as 
so  great  stress  was  laid  upon  the  gods  to  maim  or  to  heal, 
so  much  the  less  power  had  the  physician-priest,  for  was 
he  not  a  mere  tool  of  the  gods  ?  It  was  not  he  that  healed. 
Even  to  within  a  century  or  two  ago  a  "barber-surgeon," 
as  he  was  called,  was  held  in  the  greatest  contempt,  and 
the  development  which  has  led  to  the  medical  profession 


102  MEDICINE 

holding  a  place  of  eminence  in  the  minds  of  men  is  one 
of  the  most  startling  evolutions  of  modern  times. 

This  sudden  elevation  reveals  a  public  consciousness  of 
the  worth  of  true  knowledge.  Whereas  the  physician  of 
the  ancients  was  also  priest,  philosopher  and  scribe,  and 
could  not  specialize  or  attain  distinctive  knowledge  in  any 
one  branch  of  the  healing  art,  for  the  reason  that  those 
branches  were  incompletely  developed  and  not  much  was 
known  of  them,  now  the  physician  is  acutely  trained  to  a 
definite  portion  of  his  profession  and  speaks  thereon  with 
authority.  Moreover,  he  must  not  only  know  his  subject 
^.nd  know  it  well  but  he  must  be  a  man  of  culture,  of  wide 
general  knowledge  and  keen  understanding  of  the  men 
and  times  in  which  he  lives,  and  he  must  also  be  a  chemist, 
a  biologist  and  a  physicist;  indeed  there  is  not  a  branch 
of  science  which  he  does  not  subordinate  to  his  effort  to 
alleviate  pain  and  raise  the  life-standard  of  the  human 
race. 

The  peerless  knowledge  of  the  ancients  in  the  Mathe- 
matical Sciences  and  in  the  Fine  Arts  naturally  raises  the 
question  why  anatomy,  physiology  and  organic  chemistry 
were  not  independently  studied  nor  worked  out  with  any 
analytical  skill.  The  structure  and  functions  of  the  human 
body  were  little  known  and  less  understood.  That  the  con- 
fusion of  mind  incident  upon  the  commixture  of  the  Art 
of  Medicine  with  Philosophy  and  Religion  went  far  to 
cause  this  neglect  is  true,  but  it  seems  that  an  even  greater 
barrier  lay  in  the  absence  of  freedom  of  study  and  of 
expression. 

All  the  religions  of  the  past  taught  that  to  lay  critical 
hands  upon  a  body  was  wrong  and  even  impious,  and  this 
idea  was  so  firmly  rooted  that  for  centuries  such  a  pro- 
hibition is  found  in  civil  law.  In  many  cases  the  dead 
body  was  held  as  more  sacred  than  the  living,  esteemed 
peculiarly  worthy  of  reverence  and  even  worship,  and 
even  yet  the  old  idea  has  not  entirely  died  out  which  con- 
sidered anatomical  research  and  dissection  to  be  a  sacri- 


THE   ANCIENTS  103 

lege.  Knowledge  was  perilously  gained,  and  with  the 
study  of  anatomy  and  physiology  thus  under  ban  it  is  small 
wonder  that  the  physicians  were  able  to  do  little  to  stay 
the  scourges  of  the  appalling  epidemics  which  literally 
mowed  down  hundreds  of  thousands  in  the  Middle  Ages. 
Few  developments  of  human  thought  show  a  truer  follow- 
ing of  a  high  ideal  than  the  advance  made  through  cen- 
turies of  toil  to  stay  the  pain  and  alleviate  the  distress 
which  accrue  from  "the  ills  that  flesh  is  heir  to." 

In  proportion  to  the  progress  of  civilization  and  refine- 
ment, more  definite  and  well-reasoned  attempts  have  been 
made  to  remove  or  alleviate  disease  and  to  repair  any  of 
the  gross  injuries  to  which  the  human  body  is  constantly 
exposed.  Subject  as  it  is  to  the  influence  of  various 
noxious  agents  and  to  a  consequent  derangement  of  its 
functions,  to  many  painful  affections  and  to  the  loss  of 
its  powers  and  actions,  men  have  always  been  anxious  to 
remove  or  relieve  these  conditions.  Thus,  in  the  earliest 
periods  of  society,  mankind  must  have  been  aware  of  the 
relief  which  was  given  in  the  derangements  of  alimentation 
by  evacuation  and  would  probably  have  discovered,  inci- 
dentally perhaps,  that  certain  vegetable  agents  promoted 
this  operation.  In  external  injuries  they  would  find  that 
rest,  pressure,  heat  or  cold  gave  relief,  as,  for  example, 
when  pressure  stopped  an  excessive  flow  of  blood.  This 
rude  species  of  medical  and  surgical  practice  has  been 
found  to  exist  in  newly  discovered  countries,  even  when 
in  the  most  barbarous  state,  while  it  has  been  observed 
that  the  improvement  in  the  healing  art  has  been  nearly 
proportionate  to  the  advancement  of  the  other  sciences  of 
life  and  to  the  gradual  progress  of  knowledge  on  all  sub- 
jects connected  therewith. 

The  Egyptians  had  several  divinities  who  presided  over 
the  cure  of  disease.  The  principal  of  these  deities,  Isis, 
was  at  once  the  sister  and  the  wife  of  Osiris.  She  had 
demonstrated  her  eminent  medical  skill  by  recalling  to  life 


104  MEDICINE 

her  son  Horus.  Imhotep,  the  Egyptian  yEsculapius,  who 
was  one  of  the  Memphis  gods,  and  Chunsu,  the  counsellor 
of  the  sick,  were  of  lower  rank.  The  cat-headed  Pacht 
(Bubastis)  and  Apis  were  worshiped  as  the  deities  of 
parturient  women  or  of  child-blessedness,  for  children 
among  the  Egyptians  were  esteemed  a  great  blessing. 

The  medical  knowledge  of  the  ancient  Egyptians  was 
tolerably  extensive,  and,  gauged  by  the  measure  of  those 
early  ages,  by  no  means  unimportant.  It  was  at  all  events 
quite  characteristic.  Medicine  was  divided  mto  the  sci- 
ence of  higher  degree  (conjurations,  dissolving  the  charms 
of  the  gods  by  prayer,  interpretations  of  the  revelations 
received  by  the  sick  during  incubation  in  the  temples)  and 
ordinary  medical  practice.  The  former  was  pursued  only 
by  priests,  who  aimed  to  get  further  control  over  their 
people  by  pretending  to  have  command  of  Nature. 

The  pathological  knowledge  of  the  ancient  Egyptians 
comprised  a  knowledge  of  fever  and  of  diseases  of  the  eyes, 
in  the  treatment  of  which  their  physicians  enjoyed  special 
reputation  throughout  all  antiquity.  They  must  therefore 
be  regarded  as  the  earliest  oculists.  They  were  even  sum- 
moned to  foreign  courts  and  furnish  the  earliest  examples 
of  practitioners  who  traveled  among  foreign  people. 

In  physiology  they  held  that  until  the  age  of  fifty  years 
the  heart  gains  annually  about  two  drachms  in  weight,  but 
that  afterward  it  loses  about  the  same  amount  each  year, 
so  that  finally,  in  old  people,  death  is  occasioned  by  this 
continual  loss.  Also  they  assumed  that  four  demons  ruled 
over  the  body.  As  Buchta  points  out,  hunger  and  thirst 
were  not  regarded  as  bodily  wants,  but  as  quasi-poisonous 
substances  which  forced  themselves  into  the  body  and 
required  to  be  neutralized  by  eating  and  drinking,  in  order 
that  they  might  not  destroy  it.  A  similar  superstition  also 
prevailed  regarding  the  dead,  and  thus  these  too  required 
food. 

The  Egyptians,  who  did  not  shrink  from  human  dissec- 
tion as  much  as  the  Greeks,  were  indeed  acquainted  with 


THE   ANCIENTS  105 

anatomy,  but  not  to  the  degree  which  might  be  ex- 
pected from  their  other  medical  skill.  Yet  Athotis,  the  son 
of  King  Menes,  who  is  himself  said  to  have  been  a  physi- 
cian, had  written  on  anatomy.  Both  of  these  were  kings 
and  thus  furnish  evidence  of  the  high  estimation  of  medi- 
cine and  of  physicians  in  Egypt.  The  Egyptians  assumed 
theoretically  the  existence  of  two  kinds  of  vessels  and 
nerves  or  tendons,  of  which  there  were  in  the  body  from 
twenty-four  to  thirty-two.  Such  a  nerve  extends  from  the 
little  finger  to  the  heart ;  hence  the  custom  of  dipping  this 
finger  in  their  libations.  They  were  acquainted  with  the 
heart,  the  lymphatic  glands  and  the  crystalline  lens  of  the 
eye. 

When  the  method  of  embalming  is  considered,  it  is 
manifest  that  the  custom  could  result  in  no  anatomical 
knowledge,  even  if  the  persons  who  made  embalming  their 
business  had  been  of  a  different  class  from  that  to  which, 
as  a  matter  of  fact,  they  really  belonged.  The  mode  of 
procedure  in  embalming  is  clearly  known.  In  the  first 
place  it  was  determined  by  the  friends  of  the  deceased  in 
which  of  the  three  prevalent  styles  the  operation  should 
be  performed.  In  the  more  expensive  styles  patterns  were 
exhibited  for  their  selection.  If  the  most  costly  form  was 
selected,  one  of  the  sacred  scribes  marked  eight  lines,  one 
upon  the  left  side.  Following  the  direction  and  length  of 
these,  an  associate  from  the  disreputable  and  most  deeply 
despised  caste  of  the  Egyptians,  the  "paraschites,"  with  a 
sharp  stone — an  evidence  of  the  high  antiquity  of  the  cus- 
tom— made  an  incision  into  the  cavity  of  the  abdomen. 
He  then  ran  away,  so  as  not  to  be  stoned  for  his  offence 
against  the  dead. 

Now  began  the  work  of  the  embalmers,  who  existed  as 
a  guild  even  to  the  time  of  the  Roman  Empire.  The  vis- 
cera were  removed  and  preserved  in  canopen,  i.e.,  vases 
of  clay,  limestone  or  alabaster,  the  lids  of  which  were  deco- 
rated with  representations  of  one  of  the  four  genii  of  the 
dead — Amset,  Hapi,  Tuamutef  and  Khebsennuf — to  whom 


io6 


MEDICINE 


the  canope  in  question  was  dedicated.  After  the  cranial 
cavity  was  cleared  of  the  brain  by  means  of  hooks  inserted 
through  the  nose,  the  cavities  of  both  the  cranium  and 
abdomen  were  filled  with  spices,  myrrh  and  cassia.  The 
salters  then  laid  the  corpse  in  a  solution  of  carbonate  of 
soda  (natron),  where  it  was  left  for  seventy  days.  At  the 
expiration  of  this  period  it  was  again  washed  in  caustic 
soda,  then  coated  over  with  gum  and  finally  wrapped  in  a 


Fig.  i — EGYPTIANS  BANDAGING  A  MUMMY 


cloth  of  fine  linen.  In  good  mummies  the  hair  and  nails  are 
preserved,  but  the  eyeballs  have  obsidian  eyes  inserted  in 
them. 

The  corpse,  thus  prepared,  was  placed  by  the  friends  in 
a  bivalvular  wooden  coffin,  hollowed  out  to  suit  the  size 
and  form  of  the  body  and  often  adorned  with  beautiful 
hieroglyphics.  The  mummy,  thus  completed,  was  then 
placed  in  the  catacombs,  where,  as  is  well  known,  they 
have  been  found  in  a  good  state  of  preservation  after  thou- 
sands of  years. 


THE   ANCIENTS  107 

In  embalming  "of  the  second  class"  melted  cedar  resin 
was  injected  into  the  unemptied  cavities  of  the  body,  which 
was  then  salted  down  for  seventy  days,  after  which  the 
viscera  and  resin  were  removed  together.  "Embalming  of 
the  third  class"  consisted  in  simply  salting  the  body  after 
it  had  been  washed.  Besides  these  methods,  the  Egyptians 
also  often  buried  their  dead  in  the  ordinary  way.  In  fact, 
the  poor  were  even  buried  in  the  sand  without  any  shroud 
and  those  possessed  of  a  little  means  in  arched  vaults  built 
of  brick. 

The  Egyptians  were  acquainted  with  a  considerable  num- 
ber of  drugs  and  had  numerous  formulae  for  their  prepara- 
tion. Prominent  remedies  were  opium,  strychnus,  squill 
and  vegetable  remedies  in  general,  though  medicines  of 
animal  origin  and  of  a  kind  disgusting  to  modern  ideas 
also  were  employed.  The  Egyptians  made  use  of  metallic 
preparations  such  as  antimony  (a  paint  for  the  eyes),  ver- 
digris and  white-lead.  Ointments,  oils  (which,  in  conse- 
quence of  their  excellence,  were  imported  from  Egypt  by 
even  the  Greeks  in  Hippocrates'  time),  plasters,  pills 
(mixed  with  honey  and  afterward  rolled  into  form)  steam 
for  inhalations,  poultices,  enemata,  decoctions  and  such 
like  were  recognized  preparations. 

Mental  diseases  were  blamed  upon  the  demons,  and  amu- 
lets were  in  common  use,  especially  in  the  treatment  of 
diseases  of  the  nervous  system.  Astrology  was  called  into 
counsel  in  the  treatment  of  disease,  and  by  reason  of  the 
theurgic  character  of  ancient  Egyptian  character  it  was 
susceptible  of  change  with  every  variation  of  worship.  In 
the  Middle  Ages,  it  is  remembered,  Egyptian  wisdom  was 
regarded  as  identical  with  sorcery,  the  search  for  the  phi- 
losopher's stone,  alchemy  and  astrology ;  while  even  to-day 
the  gipsy  is  not  a  little  feared  by  the  ignorant  classes. 

The  astrology  of  the  Egyptian  was  not  comparable  with 
that  which  developed  in  the  valley  of  the  Euphrates.  In 
the  gray  dawn  of  antiquity  there  immigrated  into  Baby- 


io8  MEDICINE 

Ionia  from  the  north  a  Turanian  people,  the  Chaldees, 
whose  dominant  element  consisted  of  the  servants  of  the 
deity.  The  latter  thus  rose  to  be  an  influential  priesthood, 
and  accordingly  the  name  Chaldee — the  Magi  of  the  Bible 
— was  employed  to  designate  both  these  immigrants  and 
their  priests.  The  Chaldees  enjoyed  great  esteem  as 
mathematicians,  astronomers,  astrologers,  interpreters  of 
'dreams  and  (theurgic)  physicians.  Aside  from  the  Chal- 
dean Magi,  however,  Herodotus  avers  that  the  Babylonians 
had  no  regular  physicians  who  visited  the  sick,  but  the 
latter  were  exposed  upon  the  streets  and  interrogated  by 
those  who  passed.  If  any  of  these  visitors  had  recovered 
from  a  similar  disease  he  was  expected  to  counsel  the 
invalid  as  to  the  means  by  which  he  had  been  cured. 

The  Old-Persian  medicine  too,  so  far  as  can  be  judged 
from  the  exceedingly  scanty  information  now  possessed, 
was  theurgic  in  its  character.  Leprosy  was  ascribed  to 
offences  against  the  sun,  and  the  sufferer  was  compelled  to 
live  apart  from  the  healthy.  Amulets  played  an  important 
role,  for  each  city  and  every  province  had  its  genius. 
Sparkling  stones  were  worn  for  love  of  the  genii,  and  in 
this  way  originated  the  reliance  upon  and  belief  in  the 
virtues  of  stones.  They  served  to  avert  evil  and  were 
especially  useful  against  the  venom  of  serpents  and  scor- 
pions ;  they  mitigated  the  pains  of  disease  and  of  wounds, 
since  it  was  believed  that  fire  and  water,  the  male  and 
female  Genius  of  Nature,  were  active  in  them.  Hence  the 
doctrine  of  the  Magi  as  to  their  composition,  hence  the 
prescriptions  as  to  their  use.  The  Persians  possessed  an 
extensive  knowledge  of  poisons.  The  Houma-drink — a 
drink  prepared  from  the  plant  Houma  and  which  possessed 
almost  divine  powers — was  prescribed  by  the  physicians  for 
pains  in  the  limbs,  catarrhal  obstructions  and  urinary  dis- 
eases. 

In  reviewing  the  medical  culture  of  the  Phoenicians  it 
is  important  to  remember  that  in  the  papyrus  Ebers  it  is 
stated  that  one  of  its  books  is  the  work  of  a  physician  of 


THE   ANCIENTS  109 

By  bios.  What  is  known  of  this  book  permits  the  conjec- 
ture that  much  more  important  medical  knowledge  than 
has  been  heretofore  suspected  was  possessed  by  this 
Semitic  race.  Not  only  was  it  distinguished  for  its  tech- 
nical, nautical  and  meteorological  knowledge,  as  well  as 
for  its  activity  in  colonization,  its  commerce  and  its  lux- 
ury, but  it  also  exercised  an  important  influence  upon  the 
Greeks,  which  appears  in  Greek  medicine.  That  the 
Phoenicians  indulged  in  an  extremely  sensual  religious 
worship  is  known.  It  is  also  known  that  their  supreme 
deity,  Baal-Zebub  (the  god  of  flies),  the  Beelzebub  of  the 
Bible,  was  a  god  of  medicine  and  was  interrogated  as  an 
oracle  of  health  and  disease.  His  priests  were  clad  in  red 
clothing,  possibly  the  earliest  example  of  the  red  garments 
of  the  physician.  The  Carthaginians,  as  Phoenician  colo- 
nists, differed  but  slightly  in  their  medical  customs  from 
that  of  the  parent  stock. 

Early  Jewish  medicine  is  especially  conspicuous  for  its 
absence.  In  consequence  of  the  stern  prohibition  against 
contact  with  the  dead,  true  anatomy  was  not  thought  of, 
the  bones  and  vessels  being  only  very  vaguely  mentioned, 
while  nothing  is  known  of  any  Jewish  physiology.  The 
almost  complete  absence  of  a  pharmacology  among  the 
Jews  is  remarkable,  for  they  were  acquainted  with  a  great 
number  of  plants,  and  the  Egyptians,  among  whom  they 
had  lived,  had  a  large  number  of  remedies  which  they 
might  have  appropriated.  Figs,  and  the  heart,  liver  and  gall 
of  fishes  are  mentioned  as  medicines,  and  bathing  in  the 
Jordan  is  deemed  a  remedy  for  leprosy.  This  lack  of  reme- 
dies is  doubtless  to  be  explained  by  the  purely  theurgic 
character  of  Hebrew  medicine.  Yet  the  mortality  of  the 
Jews  was  not,  for  this  reason,  any  greater  than  that  of 
other  people  who  employed  "remedies"  in  abundance. 

The  Hebrews,  like  all  other  peoples,  regarded  the  preva- 
lence of  diseases,  and  especially  of  important  epidemics, 
as  punishment  inflicted  by  a  deity  on  account  of  their  sins. 


i  io  MEDICINE 

For  relief,  therefore,  they  resorted  to  repentant  prayers 
and  the  mediations  of  their  priests.  They  did  not  see  any 
need  for  physicians.  But  the  great  lawyer,  Moses,  while  he 
omitted  any  surgical  or  medical  practice,  gave  his  people 
the  first  elementary  code  of  public  hygiene.  It  contained 
the  specific  directions  in  regard  to  the  kind  and  preparation 
of  food;  the  slaughtering  of  animals;  the  burial  of  the 
dead ;  the  regulation  of  marriage  and  sexual  relations ;  the 
diagnosis  and  isolation  of  cases  of  leprosy  and  some  other 
contagious  diseases.  The  only  surgical  procedure  given 
was  that  of  circumcision,  which  was  performed  by  the 
priests. 

The  later  knowledge  of  the  Jews  is  found  in  the  Talmud, 
the  medical  contents  of  which  are  fairly  complete  for  that 
period.  Its  Surgery  embraces  a  knowledge  of  dislocations 
of  the  femur,  contusions  of  the  skull,  perforation  of  the 
lungs,  oesophagus,  stomach,  small  intestine  and  gall-blad- 
der, of  wounds  of  the  spinal  cord,  trachea,  pia  mater,  of 
fractures  of  the  ribs  (all  of  which  were  considered  very 
dangerous  unless  immediate  medical  aid  could  be  ob- 
tained), of  oral  and  nasal  polypi,  the  latter  of  which  were 
considered  a  punishment  for  past  sins.  In  sciatica  a  curi- 
ous direction  is  given  to  rub  the  hip  sixty  times  with  meat- 
broth.  Besides  the  ordinary  operations,  e.g.  venesection, 
which  was  performed  by  mechanics  or  barbers,  mention  is 
made  of  circumcision  and  of  the  operation  for  imperforate 
anus.  The  execution  of  the  latter  operation  is  described 
very  minutely. 

The  Talmudic  pathology  ascribes  diseases  to  a  constitu- 
tional vice,  to  evil  influences  affecting  the  body  from 
without  or  to  the  effect  of  magic.  It  recognizes,  among 
other  things,  the  origin  of  jaundice  from  retention  of  bile 
and  of  dropsy  from  suppression  of  urine.  The  latter  in 
general  was  divided  into  anasarca,  ascites  and  tympanites. 
Prognostically  it  is  declared  that  hydrocephalus  internus, 
or  water  on  the  brain,  is  always  fatal,  while  hydrocephalus 
externus  is  not  necessarily  so ;  that  rupture  and  atrophy  of 


THE   ANCIENTS  in 

the  kidneys  are  followed  by  death ;  that  hydatids,  or  cysts 
of  the  liver,  on  the  contrary,  are  not  fatal ;  that  suppuration 
of  the  spinal  cord,  induration  of  the  lungs,  etc.,  are  incur- 
able— views  which  may  have  been  based  upon  the  dissec- 
tion of  animals  and  may  be  considered  germs  of  pathologi- 
cal anatomy.  Sweating,  sneezing  and  dreams  promising 
a  favorable  termination  of  existing  disease  pass  for  criti- 
cal symptoms. 

In  therapeutics  natural  remedies,  both  external  and  in- 
ternal, were  employed,  as  well  as  the  arts  of  magic.  The 
rabbis,  at  other  times  so  strict,  allow  to  the  sick  even  pro- 
hibited articles  of  diet  if  they  have  a  desire  for  them. 
Among  their  special  prescriptions  may  be  noticed  onions 
for  worms;  wine  and  pepper  in  disorders  of  the  stomach; 
goat's  milk  in  dyspnoea  (labored  breathing)  ;  emetics  in 
nausea;  a  dog's  liver  for  the  bite  of  a  mad  dog;  injections 
of  oil  of  turpentine  in  cases  of  stone  in  the  bladder ;  a  drop 
of  cold  water  in  the  eye  in  the  morning,  with  warm  foot 
and  hand  baths  in  the  evening,  for  sore  eyes ;  bleeding  and 
the  warm  baths  of  Tiberias.  Asafetida  and  many  other 
drugs  are  certainly  derived  from  Grecian  medicine,  the 
laying  on  of  hands,  prayer  and  conjurations  with  less  cer- 
tainty to  the  same  source.  In  Dietetics  it  was  recommended 
before  the  age  of  forty  to  take  more  food  than  drink,  after 
that  age  to  reverse  the  habit;  after  meals  to  eat  salt  and 
then  to  drink  water  freely,  but  not  to  work  too  much  nor 
to  walk,  sleep  nor  indulge  in  wine.  On  the  other  hand,  it 
is  advised  to  form  regular  habits,  to  bathe,  anoint  and 
wash  frequently. 

The  Anatomy  of  the  Talmudists  is  based  chiefly  upon  the 
dissection  of  animals,  though  Rabbi  Ishmael,  at  the  close 
of  the  first  century,  dissected,  or  rather  "skeletonized,"  by 
boiling  the  body  (dissection  in  the  interests  of  science  was 
permitted  by  the  Talmud),  on  which  occasion  he  found  252 
(instead  of  232)  bones.  They  recognized  the  origin  of 
the  spinal  cord  at  the  foramen  magnum  and  its  termination 
in  the  cauda  equina ;  allowed  two  coats  to  the  oesophagus ; 


112  MEDICINE 

included  the  lungs  in  two  coverings  and  gave  a  special 
coat  to  the  fat  about  the  kidneys. 

In  Physiology  they  assume  cold,  heat,  dryness  and  moist- 
ures as  component  forces.  In  experimental  physiology 
they  point  out  that  removal  of  the  spleen  is  not  fatal  and 
distinguish  between  salt  solution  and  albumen  by  the  fact 
that  the  former,  under  the  influence  of  heat,  deliquesces, 
while  the  latter  coagulates. 

Hindu  medicine  is  one  of  the  oldest  in  the  world.  Like 
the  foregoing,  it  is  also  a  priestly  medicine.  In  its  whole 
extent  it  grew  up  upon  Indian  soil,  although  at  a  late 
period  foreign  views,  especially  those  of  the  Greeks,  prob- 
ably were  interwoven.  The  study  and  practice  of  the 
Indian  physicians,  however,  are  controlled  by  regulations, 
which  give  evidence  of  a  very  earnest  and  worthy  concep- 
tion of  the  medical  profession  and  embody  truths  acknowl- 
edged even  to-day. 

Certain  external  requirements  were  imposed  upon  the 
physician,  the  estimation  of  which  is  characteristic  of  the 
childlike  mind  of  the  people,  though  the  adoption  of  some 
of  them  would  seem,  if  not  necessary,  at  least  useful  for 
us  of  the  present  day.  There  were  demanded  of  the  physi- 
cian a  fine  person,  absence  of  passion,  decorum,  chastity, 
temperance,  amiability,  veracity,  consideration  for  the  sick, 
generosity,  diligence,  earnestness,  freedom  from  boasting, 
secrecy,  a  desire  for  knowledge  which  scorns  not  even  the 
lessons  of  an  enemy,  and,  above  all,  reflection  and  inde- 
pendence of  thought. 
Moreover,  it  is  said : 

"A  physician  who  desires  success  in  his  practice, 
his  own  profit,  a  good  name  and  finally  a  place  in 
Heaven  must  pray  daily  for  the  welfare  of  all  living 
creatures,  first  of  the  Brahmans  and  of  the  (sacred) 
cow.  .  .  .  The  physician  should  wear  his  hair 
short,  keep  his  nails  clean  and  cut  close  and  wear  a 
sweet-smelling  dress.  Let  his  speech  be  soft,  clear, 


THE  ANCIENTS  113 

pleasant.  Transactions  in  the  house  should  not  be 
bruited  abroad." 

The  last  advice  is  found  also  in  the  Hippocratic  oath. 

Medical  instruction,  which  comprises  the  learning  by 
heart  of  the  medical  doctrines  taught  orally,  is  imparted  by 
the  Brahmans  and  begins  in  early  youth,  a  regulation 
which  is  found  also  among  the  Greeks.  The  pupil  must 
first  select  a  good  text-book  and  then  a  good  teacher.  In- 
struction embraces  the  theory  of  medicine  and  a  practical 
course  at  the  bedside,  with  the  performance  of  some  opera- 
tions. The  pupil  must  begin  to  study  early  in  the  morning 
(after  having  rinsed  his  mouth  and  prayed  to  the  cow  and 
the  gods)  and  cease  late  in  the  evening.  Conference  with 
fellow  students  is  enumerated  among  the  means  adapted  to 
give  the  student  a  better  insight  into  his  studies. 

The  general  Pathology  of  the  Hindus,  says  J.  H.  Baas 
in  his  excellent  'History  of  Medicine/  points  out  as  the 
characteristics  of  health  a  serene  spirit,  clear  sense  and 
perfect  understanding,  uniform  warmth  from  a  uniform 
mixture  of  the  fluids  and  elements  and  undisturbed  regular- 
ity of  the  secretions  and  functions  of  the  body.  Diseases 
are  divided  into  natural  and  supernatural  (the  work  of 
demons),  with  subordinate  classes,  as  accidental,  corporeal, 
mental,  original  and  complicating,  secondary,  internal  and 
external.  Pain  is  considered  a  symptom  of  all  diseases  and 
fever  a  symptom  of  all  severe  affections.  Etiologically 
diseases  are  ascribed  to  an  unequal  or  perverted  action  of 
the  five  common  elements — ether,  air,  fire,  water  and  earth. 
These,  however,  in  the  first  place,  through  the  influence  of 
food,  season,  conditions  of  the  atmosphere  and  the  climate, 
form  proximate  causes  8f  disease,  while  corruption  of  the 
three  "elementary  fluids,"  bile,  mucus  and  air,  is  looked 
upon  as  the  remote  cause. 

Other  evils  arise  from  draughts  of  air,  water,  the  pas- 
sions, bad  habits  of  life,  insufficient  clothing  and  unclean 
dwellings.  Worms  also  play  an  important  part  in  the 
etiology  of  diseased  conditions  of  the  body  or  its  parts  and 


114  MEDICINE 

the  existing  superstition  to  this  effect  probably  had  its 
origin  in  this  Indian  idea. 

Operative  surgery  attained  such  a  position  among  the 
Hindus  that  they  did  not  shrink  from  the  greatest  and 
most  difficult  operations.  First  may  be  noticed  the  dressing 
of  wounds,  concerning  which  the  Ramayana  says : 

"The  wounded  in  battle  should  be  quickly  picked  up, 
carried  into  a  tent,  the  bleeding  stayed  and  upon  the 
wounds  should  be  dropped  an  anodyne  oil  with  the 
juice  of  healing  herbs." 
Next  may  be  quoted  the  apothegm: 

"The  fire  cures  diseases  which  cannot  be  cured  by 
physic,  the  knife  and  drugs." 

Their  special  pathology  includes  among  internal  diseases 
rheumatism,  gout,  haemorrhoids,  inflammations,  fever, 
catarrh,  diabetes  mellitus  (first  mentioned  among  the 
Greeks  by  Demetrius  of  Apamea),  diarrhoea,  jaundice, 
cough,  verminous  diseases,  epilepsy,  mania  a  potu,  the 
exanthemata,  dysentery  and  phthisis. 

Diagnosis  was  effected  by  the  aid  of  the  senses  and  by 
examination  of  the  sick,  and  the  physician  was  expected  to 
pay  special  attention  to  the  pulse,  the  bodily  temperature, 
the  color  of  the  skin,  the  urine  and  feces,  the  eyes>  the 
strength  of  the  voice  and  the  noise  of  the  respiration. 

Therapeutics  were  guided  by  the  curability  or  incurabil- 
ity of  the  disease.  If  the  disease  belonged  to  the  incurable 
class  the  physicians  did  not  take  the  patient  under  treat- 
ment at  all,  but  advised  him  plainly,  honestly  and  unself- 
ishly. It  is  said : 

"To  go  forth  upon  a  narrow  footpath  to  the  invin- 
cible northeastern  tcngue  of  land,  to  live  on  water  and 
air  until  this  earthly  tabernacle  sinks  down  and  his 
soul  is  united  with  God." 
Herodotus  similarly  relates: 

"Whosoever  among  the  Indians  becomes  sick  goes 
out  into  a  desert  and  lays  himself  down  there.    No  one 


THE   ANCIENTS  115 

troubles  himself  about  him,  whether  he  be  sick  or 
dead." 

If,  however,  the  disease  is  curable  attention  must  be 
paid  in  the  cure  to  the  disease  itself,  the  season,  the 
organic  fire,  the  age,  bodily  habit,  the  strength,  the  intelli- 
gence (according  to  the  Indian  ideas  the  stupid  are  cured 
more  quickly  than  the  intelligent,  because,  thinks  the  open- 
hearted  Susruta,  they  are  more  obedient),  nature,  idiosyn- 
crasies, remedies  and  the  regions  of  the  earth. 

The  Materia  Medica  of  the  Hindus  is  most  copious,  in 
fact  almost  as  rich  as  that  of  to-day.  It  embraces  reme- 
dies from  the  animal,  vegetable  and  mineral  kingdoms, 
together  with  the  arts  of  magic.  Remedies  are  used  both 
externally  and  internally;  they  are  divided  into  pharmaco- 
dynamic  classes  and  are  either  simple  or  (as  is  more  fre- 
quently the  case)  exceedingly  complex  in  their  nature. 
Venesection  and  cupping,  especially  the  former,  play  an 
important  part.  Even  inhalations  into  the  mouth  and  nose 
by  the  aid  of  tubes  are  known. 

In  India  the  ancients  had  hospitals.  Inoculation  of  the 
natural  and  artificial  virus  of  small-pox  was  practised  with 
a  prophylactic  view.  The  Brahmans  always  performed 
this  operation  in  the  beginning  of  the  warm  season.  The 
skin  was  rubbed,  a  few  incisions  made  and  virus  of  the 
preceding  year,  with  which  pledgets  of  cloth  had  been 
saturated,  was  bound  upon  the  abraded  surface.  The  per- 
sons thus  inoculated  were  compelled  to  remain  in  the  open 
air  (Indian  method  of  inoculation).  Boys  were  inoculated 
upon  the  outside  of  the  forearm,  girls  upon  the  upper  arm. 
Vaccination  is  now  obligatory  in  the  larger  cities,  but  else- 
where the  old  plan  is  generally  carried  out. 

Dietetics  are  carried  to  the  extreme  and  carefully  regu- 
lated. The  Hindus  are  forbidden  to  eat  meat. 

Their  knowledge  of  Toxicology  is  considerable.  Such  an 
acquaintance  with  natural  history  as  is  necessary  to  a 
knowledge  of  remedial  agents  is  possessed  in  a  remarkable 
degree.  On  the  other  hand,  Anatomy  forms  the  weakest 


ii6  MEDICINE 

side  of  Indian  medicine.  This,  however,  ought  not  to 
occasion  much  surprise  when  the  prohibition  of  contact 
with  the  dead  is  considered  an  offence  always  to  be  ex^ 
piated,  though  only  ligfitly.  The  method  of  preparing 
bodies  and  the  sole  instruments  employed  in  this  process 
are  very  original,  but  certainly  not  adapted  to  afford  a 
good  insight  into  tfie  structure  of  the  human  body. 

"Let  the  physician  leave  a  corpse  fastened,"  it  is 
ordered,  "together  with  its  receptacle,  in  a  brook,  to 
macerate  in  a  clear  place — a  corpse  which  has  a  body 
uninjured,  uncorrupted  by  poison,  unshaken  by 
chronic  disease,  unhandled  a  hundred  times,  un- 
clothed— and  draw  it  out  when  maceration  is  com- 
pleted. The  corpse  at  the  expiration  of  seven  days 
should  then  be  rubbed  with  pieces  of  bark ;  he  can  then 
with  his  eyes  see  the  skin  and  all  the  external  and 
internal  parts." 

Hindu  medicine  must  be  assigned,  at  all  events,  a  superi- 
ority over  the  Egyptian  and  the  Talmudic;  indeed,  it  may 
claim  even  the  very  first  rank  among  those  examples  of 
medical  culture  which  have  not  experienced  a  continuous 
development.  That  it  was  not  far  behind  Greek  medicine, 
both  in  the  extent  of  its  doctrines  and  in  its  internal  elabo- 
ration, furnishes  only  a  very  superficial  comparison.  It 
cannot  fail  to  command  admiration  when  the  very  early 
period  in  which  it  developed  and  attained  so  high  a  grade 
is  considered. 

The  Chinese  are  little  further  advanced  now  than  they 
were  ages  ago,  except  in  the  large  cities,  where  foreign 
influences  cannot  help  but  be  felt.  The  ancient  and 
unlimited  liberty  of  choosing  one's  occupation  in  China  has 
resulted  in  making  the  medical  profession  enormous  in 
point  of  numbers.  From  the  earliest  times,  therefore,  there 
have  been  found  several  physicians  in  every  village.  In 
China  any  person  may  be  a  physician  to  the  poor  without 
having  given  any  previous  evidence  of  his  professional 


THE   ANCIENTS  117 

competency.  Any  one,  moreover,  may  assume  the  titk  of 
physician.  The  court  physicians  only,  as  a  matter  of  pre- 
caution, are  compelled  to  pass  an  examination  before  a 
college  at  Pekin. 

Chinese  apothecaries,  before  they  can  carry  on  their 
business,  must  have  passed  an  examination  and  must  ex- 
hibit a  diploma  from  the  examining  board.  Powerful 
remedies,  like  opium,  arsenic,  etc.,  are  forbidden  to  be  dis- 
pensed by  them  without  the  prescription  of  a  physician. 
The  pharmacies  are  fully  supplied  with  the  necessary  drugs 
(a  Chinese  pharmacopoeia  contains  650  different  kinds  of 
leaves)  and  they  are  kept  in  a  very  orderly  condition. 
Besides  pills  as  large  as  musket-balls,  their  proprietors  also 
prepare  love  potions.  The  prescriptions  of  physicians  are 
prepared  by  the  apothecary,  but  the  latter  combines  also 
with  his  business  the  occupation  of  fortune-telling. 

Chinese  surgery  embraces  the  practice  of  acupuncture, 
which  is  regarded  as  a  universal  remedy  and  has  for  its 
object  the  quickening  of  the  "vital  spirits."  It  is  practised 
by  twisting  or  driving  in  a  needle  inserted  into  the  body. 
By  this  operation  a  free  passage  is  supposed  to  be  made 
for  the  "winds."  Besides  this,  Chinese  surgery  includes 
the  application  of  moxas,  cupping,  inoculation  (which  the 
physician  Go-mei-sckan  is  said  to  have  invented  about 
A.  D.  1000)  and  paracentesis  of  the  eye  and  bleeding.  The 
latter  operation  is,  however,  practised  rarely  and  is  per- 
formed with  a  small  lancet,  after  which  tallow  and  oil  are 
applied  to  the  wound  without  any  bandage.  Enemata  are 
not  employed,  since  they  are  offensive  to  the  modesty  of 
the  dignified  Chinese.  Under  ordinary  circumstances  they 
make  shift  with  poultices.  In  this  line  cats'  liver  and 
fowls'  entrails  are  specially  popular,  while  fractures  are 
treated  by  extension. 

Kneading  of  the  muscles  (massage),  which  is  also  said 
to  have  been  in  use  2,000  years  before  the  present  era 
(though,  according  to  Wernich,  of  Japanese  origin),  is 
likewise  practised.  The  Chinese  also  claim  to  have  been 


ii8  MEDICINE 

able  for  thousands  of  years  to  produce  anaesthesia  by  means 
of  the  preparation  Mago.  Inoculation  of  modified  small- 
pox, too,  has  been  practised  by  them.  Their  surgeons  are 
extremely  ignorant,  are  assigned  to  inferior  service  and 
receive  little  pay. 

The  pathology  of  the  Chinese  is  very  incomplete.  All 
diseases,  especially  epidemic  diseases,  are  ascribed  to  spir- 
its and  winds,  cold  and  warm  humors,  etc.,  and  are  as- 
signed, in  accordance  with  their  benign  or  malign  character, 
to  Yo  (the  good  principle)  or  Yn  (the  evil  principle).  To 
Yo  belongs  acute  inflammatory  fever,  to  Yn  hectic  fever, 
etc.  There  are,  according  to  Chinese  pathology,  10,000 
varieties  of  fevers.  Among  their  diagnostic  procedures  are 
examination  of  the  tongue  and  the  eyes  and  feeling  of  the 
pulse.  The  pulse  flows  from  the  "spirits"  of  a  certain  part 
of  the  body,  which  manifest  their  presence  in  a  given  place. 
By  means  of  it  both  the  cause  and  the  seat  of  disease  are 
to  be  found. 

The  art  of  feeling  the  pulse  is  very  old  and  extremely 
elaborate.  It  is  performed  elegantly  by  placing  several 
fingers  upon  a  certain  point  and  then  raising  or  depressing 
each  in  turn,  as  is  done  in  playing  the  piano — the  Chinese 
"play  upon"  the  pulse  instead  of  feeling  it.  In  this 
practice  the  changes  of  the  moon  and  the  season  of  the 
year  are  considered,  according  to  certain  rules.  The  per- 
formance often  lasts  several  hours.  In  diseases  of  the 
heart  the  left  pulse  is  investigated,  in  those  of  the  liver  the 
right,  etc.  Each  speck  upon  the  tongue  and  every  discol- 
oration of  this  organ  points  to  special  diseases  and  viscera. 

Chinese  pharmacology  contains  remedies  from  the  vege- 
table and  animal  kingdom  almost  exclusively  and  is  very 
copious.  It  includes  elephant's  bile,  dried  spiders,  bugs, 
toads,  lizards,  snakes,  claws,  ears,  tongues,  hearts  and 
livers  of  numerous  animals,  excrements,  dragon-bone, 
cotton,  ivory,  musk,  rhubarb,  gentian,  camphor,  Chinese 
seeds,  leaves  in  large  doses  and  innumerable  other  things. 
The  genuine  ginseng-root  (worth  about  $25  an  ounce) 


THE  ANCIENTS  119 

and  the  edible  nests  of  the  swallow  are  considered-  veri- 
table panaceas  and  are  specially  prized  by  the  Chinese. 

In  therapeutics  great  importance  is  laid  upon  strict  diet, 
frequent  baths,  etc.  The  chief  task  of  the  physician,  after 
making  his  diagnosis,  is  to  remove  the  materia  morbi, 
which  has  entered  by  way  of  digestion,  the  nerves  or  the 
circulation.  In  general  the  maxim  'contraria  contrariis*  is 
followed,  hence  in  debility,  e.  g.,  the  extract  of  tiger's 
blood  is  prescribed.  Almost  every  animal  supplies  a 
distinct  specific,  particularly  its  blood  and  its  liver. 
Often  too,  especially  among  the  wealthy,  the  whole  store 
of  Chinese  remedies  must  be  'exhibited  until  the  proper 
specific  is  found.  If  the  patient  dies,  according  to  the 
Chinese  idea,  he  is  indeed  cured  by  the  suitable  remedy, 
but  the  physician  has  not  had  the  time  to  rid  him  of  his 
poisonous  drug,  and,  as  the  result  of  this  unfortunate 
want  of  time,  the  patient  is  doomed. 

Anatomy  and  physiology  occupy  the  lowest  grade  in 
Chinese  medical  science,  though  a  few  very  old  and 
imperfect  plates  are  in  existence.  In  their  veneration  of 
the  dead,  dissection  of  the  human  body  is  of  course  ex- 
cluded. The  Chinese  assume  six  chief  organs  in  which 
the  "moisture"  is  located,  viz.,  the  heart,  liver,  two  kid- 
neys, spleen  and  lungs ;  six  others  in  which  is  the  seat  of 
"warmth,"  viz.,  the  small  and  large  intestine,  the  gall- 
bladder, the  stomach  and  the  urinary  apparatus.  They 
enumerate  three  hundred  and  sixty-five  bones.  The  Chi- 
nese, in  place  of  the  fire  and  earth  of  the  Greeks,  class 
wood  and  metal  as  elements  and  heat  and  moisture  (whose 
union  produces  life,  their  separation  death)  are  regarded 
as  fundamental  qualities.  The  circulation  flows  outward 
from  the  lungs  five  times  in  twenty-four  hours  and  termi- 
nates in  the  liver.  The  bile,  as  it  is  one  of  the  most 
powerful  remedies  so  also  is  it  the  special  seat  of  courage ; 
the  lungs  give  origin  to  the  voice ;  the  spleen  is  the  seat 
of  reason  and,  with  the  heart,  furnishes  ideas;  the  liver 


120  MEDICINE 

is  the  granary  of  the  soul,  while  the  stomach  is  the  resting- 
place  of  the  mind. 

In  the  pathology  of  the  ancient  Japanese  medicine  ex- 
ternal and  internal  diseases  are  said  to  be  distinguished. 
A  disease  peculiar  to  the  Japanese  pathology  is  the  lesion 
of  the  spine,  called  Kakkeh.  The  most  wonderful  things 
are  regarded  as  therapeutic  measures — e.  g.,  in  small-pox 
the  decoration  of  the  sick-room  with  red  hangings.  On 
the  whole,  the  medicine  of  the  Japanese  bore  almost  as 
strong  a  theurgic  character  as  that  of  the  Chinese,  from 
whom,  as  has  already  been  seen,  it  was  adopted.  Both 
too,  may  be  considered  philosophical  sciences,  inasmuch 
as  neither  was  ever  a  sacerdotal  medicine  proper. 

Equally  ancient,  the  Celts  and  the  Teutons  possessed  a 
medical  mythology  displayed  among  the  demi-gods.  Thus 
there  is  a  female  ^Esculapius,  Eira;  another  goddess, 
Fricco,  invoked  for  fruitfulness  in  wedlock,  and  Holla, 
the  aider  of  women  in  labor.  On  the  other  hand,  Hela,  a 
ghastly  form,  received  all  those  who  died  of  disease  into 
her  residence,  Niflheim,  which  contained  the  hall,  Elidnir 
(pain)  ;  her  bed,  Koer  (disease),  and  the  table,  Hungur. 
Some  fragments  of  genuine  medical  practice  and  infor- 
mation of  a  later  period  have  been  preserved.  Thus  the 
Scandinavian  physicians  in  cases  of  dropsy  are  said  to 
have  had  recourse  to  the  actual  cautery  and  in  asthma  to 
have  resorted  to  venesection,  while  for  bearing  the 
wounded  those  warriors  were  selected  who  possessed  soft 
hands.  Their  anatomy  mentions  two  hundred  and  four- 
teen bones,  three  hundred  and  fifteen  vessels  and  only 
thirty  teeth.  Their  physiology  locates  love  in  the  liver, 
passion  in  the  bile,  memory  in  the  brain — data  which 
remind  of  Indian  ideas. 


CHAPTER  II 

THE   GREEKS 

THE  earliest  traces  of  European  medical  history  are  to 
be  found  in  the  Homeric  writings,  which,  although  they 
are  Ionic  in  origin,  at  the  time  when  they  first  clearly 
appear  had  become  indigenous  to  the  soil  of  Greece. 
Prominent  in  the  Hellenic  pantheon  was  yEsculapius,  one 
of  the  sons  of  Apollo,  who  was  reputed  to  have  the  power 
of  restoring  the  dead  to  life,  but  who  had  been  slain  by 
Jupiter  at  the  request  of  Pluto  because  he  had  restored  to 
life  an  enemy  of  the  god  of  the  underworld.  He  was  the 
pupil  of  old  Chiron,  the  centaur,  possessed  of  marvellous 
powers  of  healing  and  of  song,  and  is  usually  represented 
seated  holding  a  bundle  of  medicinal  herbs. 

He  was  deified  in  the  Greek  life,  but  only  in  the  an- 
thropomorphic sense  of  the  lesser  gods,  and  while  temples 
were  erected  in  his  honor,  they  were  merely  the  nuclei 
around  which  were  gathered  places  for  the  housing  and 
treatment  of  the  disabled  and  diseased.  Those  who  cared 
for  the  sick  in  these  places  were  called  ^Esclepiadae,  being 
both  priest  and  physician.  Their  duties  were  mainly  the 
treatment  of  surgical  cases,  except  that  dietetics  and  cli- 
matic therapeutics  were  well  understood.  These  temples 
were  generally  located  in  healthy  situations,  the  patients 
enjoyed  rest  and  leisure  and  diversions  were  plentiful  for 
the  mind.  In  fact,  they  were  not  unlike  the  modern  Spa 
and  health  resort. 

There  seems  to  have  been  no  writing  or  recording  for 
future  reference.  The  first  physician  known  to  put  his 


122 


MEDICINE 


thoughts  and  observations  down  on  paper  was  Hippocra- 
tes. So  that  it  may  safely  be  asserted  that  the  culmination 
of  Grecian  mythological  medicine  is  in  the  great  genius 


Fig.  2 — CHIRON  THE  CENTAUR  AND  -^SCULAPIUS. 

of  Hippocrates,  who  really  elevated  medicine  to  its  proper 
rank  of  a  science.  It  is  generally  admitted  that  although 
Greece  cultivated  the  arts  and  sciences  with  so  much  suc- 
cess, yet,  in  the  first  place,  she  borrowed  them  from  the 
neighboring  nations,  principally  from  Egypt  and  Phceni- 


THE    GREEKS  123 

cia.  For  a  long  time  those  in  Greece  who  wished  to  ac- 
quire a  larger  share  of  knowledge,  either  theoretical  or 
practical,  than  was  possessed  by  their  own  countrymen, 
visited  Egypt  as  the  great  storehouse  of  science  and 
learning. 

The  practice  of  medicine  remained  for  a  considerable 
time  hereditary  in  the  family  of  yEsculapius  and  in  a 
great  measure  confined  to  it.  As  the  field  of  healers  in- 
creased, practitioners  were  all  classed  under  the  general 
name  of  ^Esclepiadae,  although  this  may  have  been  nar- 
rowed to  those  who  were  both  priest  and  physician.  The 
process  of  treatment  was  mainly  magic  and  incantations 
and  not  based  on  an  exact  knowledge  of  human  anatomy 
or  its  functions. 

In  those  days  of  almost  constant  warfare  there  must 
have  been  wounds  of  all  varieties.  More  men  were  hurt 
or  disabled  temporarily  than  killed  outright,  so  that  prac- 
tical surgery  was  further  developed  than  any  other  phase 
of  the  medical  art,  and  the  treatment  of  wounds  achieved 
wonderful  results.  It  was  efficacious  in  its  simplicity;  for- 
eign bodies  were  removed,  the  wounded  parts  were  placed 
in  as  normal  a  position  as  possible  and  certain  healing 
vegetables,  either  balsamic  or  stypic,  applied.  Wine  and 
other  stimulants  were  used  to  support  the  patient  in  his 
shock  and  bandages  and  splints  were  applied  even  as  they 
are  nowadays. 

Over  a  long  period  of  several  centuries,  of  which  there 
is  scant  record  and  only  a  hint  now  and  then,  there  was 
very  little  advance  in  the  progress  of  medicine.  The 
^Esclepiadae  were  the  sole  practitioners — the  guardians  or 
superintendents  of  the  many  temples  devoted  to  yEscula- 
pius.  Of  these  there  were  several  which  became  quite  fa- 
mous as  schools — those  of  Cos,  Cnidos  and  Rhodes.  The 
priests  connected  with  these  institutions  became  divided, 
thus  early  laying  the  foundation  for  the  two  great  sects  of 
Dogmatists  and  Empirics,  which  long  divided  the  medical 
school.  The  school  of  Cos  assumed  more  of  a  philosophi- 


124  MEDICINE 

cal  cast,  attempting  to  unite  reason  with  experience,  while 
the  school  of  Cnidos  sought  mainly  to  observe  and  collect 
mere  matters  of  fact. 

The  school  of  Cnidos  is  said  to  have  laid  especial  weight 
upon  the  subjective  statements  of  the  sick,  the  relation 
of  the  symptoms  to  individual  parts  of  the  body  and  the 
use  of  active  remedies,  especially  drastics.  Less  attention 
was  devoted  to  diet.  It  cultivated  the  science  of  diagnos- 
tics and  recognised  some  auscultatory  signs — e.g.,  the 
pleuritic  friction  sound,  and  it  satisfactorily  distin- 
guished many  diseases,  such  as  phthisis,  typhus,  diseases 
of  the  urinary  bladder,  the  kidneys,  the  bile,  etc.  The 
Cnidians  also  performed  even  major  operations,  like 
trepanning  the  ribs  and  excision  of  the  kidneys,  and, 
though  always  empirics,  they  were  bold  operators.  In 
opposition  to  the  physicians  of  Cos,  however,  they  dis- 
carded venesection. 

The  school  of  Cos  (which  was  flourishing  as  early  as 
600  B.  c),  in  contrast  to  that  of  Cnidos,  cultivated  espe- 
cially objective  investigations,  symptomatology,  prognosis, 
the  relation  of  the  symptoms  to  the  entire  body,  etiology 
and  expectant  and  mild  therapeutics,  though  it  recom- 
mended venesection;  in  short,  it  practised  all  that  is 
worthy  of  praise  in  the  medicine  of  Hippocrates  and  the 
Hippocratists.  These  two  schools  are  the  first  examples 
of  those  two  opposing  tendencies  which  have  characterized 
medicine  down  to  the  present  day. 

The  name  of  Pythagoras,  who  founded  the  so-called 
Italian  school,  stands  preeminent,  but  even  his  history  is 
enveloped  in  much  obscurity.  He  devoted  most  of  his  life 
to  the  study  of  natural  knowledge  and  advanced  the  various 
departments  of  science,  especially  in  the  knowledge  of  the 
structure  and  actions  of  the  human  frame.  He  is  said  to 
have  dissected  the  bodies  of  animals  and  to  have  known 
something  of  anatomy.  He  taught  large  bodies  of  students 
at  Crotona  and  was  a  man  with  a  mind  far  above  his  time. 
He  travelled  extensively  throughout  Egypt,  where  he 


THE    GREEKS  125 

learned  mathematics  and  other  branches  of  Egyptian 
knowledge.  He  believed  that  the  soul  of  man  emanated 
from  a  God  and  was  immortal,  that  the  basis  of  life  was 
heat. 

But  while  Pythagoras  applied  salves  and  poultices  to 
wounds,  he  did  not  approve  of  or  practice  surgery.  Diet 
and  gymnastics,  he  declared,  must  maintain  health.  Dis- 
ease was  due  to  the  demons,  hence  prayers,  offerings  and 
music  were  used  to  restore  harmony.  His  followers  be- 
lieved that  magic  resided  in  certain  plants,  especially  the 
cabbage,  which  was  a  special  food  of  the  sect. 

Gymnastic  medicine  was  a  phase  in  the  science  on  which 
the  Greeks  laid  special  stress.  There  were  schools  founded 
for  the  practice  of  gymnastic  exercises  under  charge  of 
trainers  who  supervised  the  health  of  their  pupils,  treated 
injuries  and  also  internal  diseases.  They  were  often 
capable  physicians,  but  had  no  standing  as  such. 

Among  the  pupils  of  Pythagoras,  Alcmaeon  of  Crotona 
was  the  most  famous  in  medicine.  He  was  manifestly  the 
first  (animal)  anatomist  and  is  said  to  have  discovered  the 
optic  nerves  and  the  Eustachian  tubes.  Health,  he  af- 
firmed, depends  upon  the  harmony,  disease  upon  the  dis- 
cord of  the  component  parts  of  the  body ;  of  heat  and  cold, 
dryness  and  moisture,  bitterness  and  sweetness,  a  similar 
antithesis,  a  doctrine  amplified  in  later  systems  of  medi- 
cine. His  theory  of  hearing  is  well  worth  notice: 

"We  hear  with  the  ear  because  it  contains  a  vacuum 
and  this  occasions  the  sound.  In  the  cavity,  however, 
the  sound  is  generated,  the  air  resounding  against  it." 

The  atomic  school  presented  a  widely  different  purview. 
This  school  sought  in  matter  the  foundation  of  the  world 
and  of  thought ;  indeed  it  professed  to  find  the  principle  of 
all  things  in  the  infinitely  minute  identical,  altho  these 
atoms  were  not  eternal  nor  inimitably  divisible.  Within 
these  were  believed  to  reside  order,  position,  form  and 
motion.  They  differ  in  size,  and  to  this  difference  their 
weight  corresponds.  The  differences  of  the  elements,  fire, 


126  MEDICINE 

water,  air  and  earth,  depend  upon  differences  in  the  form 
and  size  of  the  atoms. 

The  soul,  it  was  said,  consists  of  round  and  smooth 
atoms,  and  its  expressions,  like  life  in  general,  are  a  result 
of  the  motion  of  the  atoms.  These  smooth  and  round 
atoms  exist  in  the  whole  body.  In  special  parts  they  are 
particularly  active — e.g.,  so  that  the  heart  occasions 
wrath,  the  liver  desire,  the  brain  thought.  The  percep- 
tions of  the  senses  originate  in  the  motion  of  the  atoms  of 
external  objects  (whose  image  they  are)  toward  the 
organs  of  sense  and  produce  in  these  organs  a  palpable 
impression,  the  perception.  Spirit  and  body  are  identical ; 
a  healthy  condition  of  the  brain  implies  mental  health  and 
disease  of  the  same  organ  implies  mental  disease. 

To  a  great  extent  the  way  seems  to  have  been  prepared 
for  the  coming  of  a  leader  in  science.  The  power  and 
civilization  of  Greece  had  reached  its  zenith;  great  mili- 
tary expeditions  against  Persia  had  been  successful.  No 
other  nation  had  approached  her  in  any  field  of  learning — 
history,  art,  philosophy — and  she  had  the  world's  greatest 
statesmen.  The  art  of  writing  had  come  over  from  the 
Phoenicians,  so  that  records  of  all  sorts  were  kept.  Hip- 
pocrates, called  the  Great  (460  B.  c.),  came  from  a  family 
of  physicians  and  received  a  thorough  education  both  at 
home  and  abroad.  He  recognized  the  great  fundamental 
truth — that  the  basis  of  all  knowledge  is  the  accurate  ob- 
servation of  actual  phenomena  and  that  the  correct  gener- 
alization of  these  phenomena  should  be  the  sole  foundation 
of  human  reasoning.  He  was  thus  a  mixture  of  the  two 
great  schools  which  were  formed  after  his  death  and  which 
divided  the  medical  profession  for  many  years  into  dog- 
matists and  empirics. 

Hippocrates  was  a  patient  and  very  accurate  observer 
and  an  industrious  writer,  being  the  first  to  keep  full  rec- 
ords of  all  his  studies  and  observations.  He  is  justly  called 
the  "Father  of  Medicine."  Especially  was  he  the  creator 
of  profane,  as  distinguished  from  sacerdotal  medicine 


THE    GREEKS  127 

which  had  prevailed  until  his  day ;  of  public,  in  place  of  the 
preceding  secret  medicine.  In  a  word,  he  was  the  great 
founder  of  scientific  medicine  and  of  artistic  practice. 

The  general  pathological  views  of  the  Hippocratists  are 
based  upon  the  assumption  of  the  four  elements,  water, 
fire,  air  and  earth,  whose  mixture  and  cardinal  properties 
— dryness,  warmth,  coldness  and  moisture — form  the  body 
and  its  constituents.  To  these  correspond  the  cardinal 
fluids,  yellow  bile,  blood,  mucus  and  black  bile,  in  the  order 
mentioned.  (Herein  lies  the  first  theory  of  humoral 
pathology.)  Health  consists  in  a  uniform  action  and  reac- 
tion, disease  in  an  irregular  action  and  reaction  of  all  these 
upon  and  between  each  other. 

Diseases  are  cured  by  restoration  of  the  disturbed  har- 
mony in  being  and  the  action  of  the  elements,  elementary 
qualities,  cardinal  fluids  and  cardinal  forces.  Nature,  or 
the  vital  force  inherent  in  the  body,  accomplishes  the  cure, 
however,  in  the  best  way.  If  Nature  works  undisturbed, 
the  disease  runs  a  regular  course  through  the  three  stages 
of  crudity,  coction  and  crisis.  In  the  first  of  these  a  de- 
generation of  the  fluids  predominates ;  in  the  second  they 
are  prepared  for  evacuation ;  in  the  third  they  are  removed. 
If  this  course  fails,  and  especially  if  the  "crisis"  is  wanting, 
there  result  secondary  diseases  or  incurable  conditions. 
The  crises  occur  particularly  upon  the  odd,  so-called  criti- 
cal, days. 

Hence  the  interference  of  the  physician  (and  in  this  his 
art  consists)  is  directed  always  to  choosing  the  right  in- 
stant for  lending  aid.  This  is  especially  the  case  in  fevers, 
which  are  caused  by  heating  or  excess  of  mucus  due  to  a 
check  of  the  secretions.  Besides  the  proximate  causes  of 
disease  mentioned  here  and  above,  Hippocrates  constructed 
especially  the  important  doctrine  of  remote  causes.  Such 
are  offences  against  a  judicious  mode  of  life,  climatic  and 
meteorological  influences,  the  peculiarities  of  the  season, 
endemic  and  epidemic  constitution,  place  of  residence  and 
similar  predisposing  causes. 


128  MEDICINE 

To  this  was  joined  dietetics,  a  science  also  founded  by 
Jlippocrates.  This  science  regarded  the  age — "old  persons 
use  less  nutriment  than  the  young" ;  the  season — "in  winter 
abundant  nourishment  is  wholesome,  in  summer  a  more 
frugal  diet";  the  bodily  condition — "lean  persons  should 
take  little  food,  but  this  little  should  be  fat ;  fat  persons,  on 
the  other  hand,  should  take  much  food,  but  it  should  be 
lean,"  and  similar  rules.  In  addition,  respect  was  also  paid 
to  the  easy  digestibility  of  food — white  meat  is  more  easily 
digested  than  dark — and  to  its  preparation.  Water,  barley- 
water  and  wine  were  recommended  as  drinks.  Baths, 
anointing,  gymnastic  exercises  and  the  frequent  use  of 
emetics  were  also  commended  as  dietetic  measures,  and 
the  dietetic  principles  of  Hippocrates  in  febrile  diseases  are 
substantially  observed  at  the  present  day.  By  means  of 
such  precepts  Hippocrates  extended  the  doctrine  of  indica- 
tions, which  constitutes  one  of  his  greatest  services  to 
medicine. 

The  diagnostics  of  Hippocrates  (though  he  does  not  rec- 
ognize any  such  special  branch)  was  founded  especially 
upon  objective  investigation  by  means  of  the  senses  and 
made  use  of  every  aid.  The  ear  applied  to  the  chest  of  a 
patient  suffering  with  pneumonia  supplied  a  knowledge  of 
the  mucous  rale  ("like  the  bubbling  of  boiling  vinegar")  ; 
the  sight  furnished  a  survey  of  secretion  and  excretion,  the 
bodily  frame,  the  attitude  of  the  body  and  its  members,  the 
gait,  etc.;  feeling  (the  hand  upon  the  chest  or  abdomen) 
supplied  an  idea  of  the  bodily  temperature  and  perhaps 
likewise  of  the  pulse  (though  he  certainly  knew  nothing  of 
counting  the  latter),  and  the  taste  and  sense  of  smell 
equally  were  put  to  service. 

One  of  the  chief  services  of  Hippocrates  to  medicine 
was  the  foundation  of  the  science  of  prognosis.  This  was 
based  upon  the  excellent  maxim : 

"In  order  to  be  able  to  prognosticate  correctly  who 
will  recover  and  who  will  die,  in  whom  the  disease 


THE   GREEKS  129 

will  be  long,  in  whom  short,  one  must  know  all  the 
symptoms  and  must  weigh  their  relative  value." 
It  considered  the  perspiration,  the  sleep,  mucous  rales  in 
the  throat,  the  visage  (facies  Hippocratica)  and  the  ap- 
pearance or  absence  of  the  "crises"  on  the  appointed  days. 
In  etiology  he  paid  particular  attention  to  age,  constitu- 
tion, meteorological  influences,  etc.,  as  is  seen  in  the  fol- 
lowing passage : 

"Catarrhs  are  dangerous  in  old  people  when  a  dry 
spring  follows  a  winter  with  south  winds  and  rains. 
If,  however,  the  summer  is  dry  and  north  winds  pre- 
vail, with  south  winds  in  a  rainy  autumn,  coughs, 
hoarseness  and  catarrhs  arise." 

The  surgical  knowledge  of  Hippocrates  was  consider- 
able, both  as  regards  the  number  of  diseases  recognized  by 
him  and  their  treatment  with  or  without  operation.  Frac- 
tures are  handled  particularly  well  as  regards  the  method 
of  reduction  and  dressing,  the  mode  of  repair  and  the 
duration  of  this  process.  If  a  fracture  is  healed  with  con- 
siderable shortening,  he  is  of  the  opinion  that  it  is  better  to 
break  the  corresponding  sound  bone,  so  as  to  equalize  the 
shortening.  The  same  may  be  said  of  dislocations.  Hip- 
pocrates recognizes  dislocations  of  the  humerus  inward, 
downward  and  outward: 

"The  head  of  the  humerus  is  often  luxated  (dislo- 
cated), but  not  upward,  in  consequence  of  the  acro- 
mion;  nor  backward,  by  reason  of  the  scapula;  nor 
forward,  in  consequence  of  the  biceps  muscle;  but 
rarely  inward  or  outward,  yet  frequently  and  chiefly 
downward." 

He  employs  also  a  great  number  of  methods  of  reduc- 
tion. Diseases  of  the  joints  (and  their  treatment  by 
massage)  and  wounds,  especially  of  the  skull,  are  well 
managed.  The  latter,  in  consequence  of  the  fact  that, 
until  the  time  of  the  discovery  of  explosive  weapons,  arms 
designed  to  strike  or  cut  were  used,  formed  the  favorite 
field  of  surgical  labor.  Hippocrates  also  recognized  the 


130  MEDICINE 

fact  that  wounds  of  one  of  the  cerebral  hemispheres  pro- 
duce paralysis  or  spasms  of  the  opposite  side.  The  treat- 
ment and  healing  of  wounds  by  first  and  second  intention 
fistulae,  ulcers  and  tumors  were  also  judiciously  discussed 
Hernia  was  less  fully  treated.  The  hot  iron  was  employee 
frequently,  a  practice  to  which  reference  is  made  especially 
in  the  famous  aphorism: 

"What  drugs  fail  to  cure,  that  the  iron  (or  knife] 
cures;  what  iron  cures  not,  that  the  fire  cures;  bul 
what  the  fire  fails  to* cure,  this  must  be  called  in- 
curable." 

His  surgical  therapeutics  recognizes  a  very  judicious 
plan  for  reposition  of  the  gut  in  prolapsus  ani.  Othei 
surgical  remedies  were  bandages,  poultices,  plasters,  oint- 
ments, styptics,  caustics,  cold  and  compression,  supposi- 
tories, pessaries,  enemata,  cupping,  etc.  The  rudiment* 
of  orthopaedic  surgery  are  also  to  be  found  in  Hippocrates 
who,  as  Kroner  points  out,  treats  club-foot  with  suitabl< 
manipulations,  bandages  and  proper  shoes. 

The  most  brilliant   and   eternal   contributions  of  Hip- 
pocrates to  medicine  are  his  therapeutic  maxims: 
"Follow  Nature." 

"The  physician  is  a  servant,  not  a  teacher  o; 
Nature." 

"The  physician  should  benefit  or  at  least  not  in 
jure." 

He  was  not  prejudiced  nor  devoted  to  a  stereotypec 
system : 

"We  should  examine  also  the  strength  of  the  sick 
to  see  whether  they  may  be  in  condition  to  maintair 
a  spare  diet  to  the  crisis  of  the  disease." 

"Complete  abstinence  often  acts  very  well,  if  the 
strength  of  the  patient  can  in  any  way  maintain  it.' 
"In  the  application  of  these  rules  we  must  be  al- 
ways mindful  of  the  strength  of  the  patient  and  o; 
the  course  of  each  particular  disease,  as  well  as  o- 


THE    GREEKS  131 

the  constitution  and  ordinary  mode  of  life  with  re- 
spect to  both  food  and  drink." 

In  hygienic  matters  Hippocrates  advises  one  to  observe 
what  he  tolerates  well  and  what  badly,  and  to  manage  ac- 
cordingly; to  labor,  rest,  sleep  all  in  their  due  season;  not 
to  eat  too  little  nor  with  too  absolute  regularity,  that  de- 
viation from  the  rule  may  not  produce  harm;  to  drink 
pure  spring-water,  as  well  as  wine  mixed  with  water  more 
or  less,  according  to  the  season;  occasionally  to  get  a 
little  tipsy,  so  that  accidental  excesses  may  not  occasion 
harm. 

Among  his  numerous  remedies  (265  have  been  enu- 
merated, in  spite  of  his  constantly  emphasizing  the  assist- 
ance of  Nature)  Hippocrates  employed  chiefly  vegetable 
substances,  though  drugs  derived  from  the  animal  kingdom 
also  were  not  discarded.  Some  of  these  remedies  were 
also  articles  of  food — e.  g.,  the  flesh  of  the  horse,  ass,  fox 
and  dog,  cabbage-juice,  seven  pints  of  ass'  milk  as  a  mild 
purgative.  Metallic  remedies  were  also  recognized,  such 
as  copper,  alum  and  lead. 

The  anatomical  knowledge  of  Hippocrates  was  very  im- 
perfect, as  must  naturally  have  been  the  case,  inasmuch 
as  it  was  based  upon  the  dissection  of  animals  only.  The 
different  parts  were  not  kept  distinct  enough  from  each 
other,  but  were  often  interchanged,  intermingled  and  arti- 
ficially constructed.  In  detail  the  bones  were  best  known, 
while  misty  views  alone  prevailed  with  reference  to  the 
muscles.  The  intestines  were  fairly  well  distinguished. 
Nerves,  sinews  and  ligaments  were  confounded  together, 
while  as  regards  the  vessels  (which  contained  partly  blood 
and  partly  pneuma),  and  especially  as  to  their  course,  his 
views  were  most  singularly  artificial.  He  was  acquainted 
with  the  pericardium,  the  two  ventricles,  the  thickness  of 
the  walls,  the  muscular  nature  and  internal  appearance 
of  the  heart ;  he  knew  that  the  left  ventricle  is  empty  after 
death,  and  he  was  acquainted  with  the  valves  of  the  great 
vessels  of  the  heart.  He  also  knew  that  the  auricles  do 


132 


MEDICINE 


not  contract  exactly  contemporaneously  with  the  ventri- 
cles. Four  pairs  of  vessels  were  assumed,  one  originating 
behind  from  the  nape,  a  second  out  of  the  head  behind 
the  ears,  the  third  from  the  temples,  the  fourth  from  the 
brow. 

The  brain  he  regarded  as  a  gland  which  condenses  into 
mucus  the  ascending  vapors,  which  then  flow  down 
through  the  nose.  The  kidneys  are  also  glands,  connected 
with  the  bladder  by  "veins."  The  liver  is  an  organ  for  the 
preparation  of  blood  and  bile,  has  five  lobes  and  is  more 
vascular  than  all  other  parts.  The  vena  cava  with  several 
bronchia  pass  from  it  to  the  heart  and  one  vein  goes  from 


Fig.  3 — GREAT  PHYSICIANS  OF  ANTIQUITY 

it  to  the  spleen.  Hippocrates  was  acquainted  with  the 
duodenum,  the  colon,  the  mesentery,  the  seminal  vesicles 
and  the  rectum,  but  no  clear  description  of  them  is  given 
anywhere.  The  nerves  are  hollow  and  convey  the  'spiritus 
animalis'  throughout  the  body,  an  idea  which  occasioned 
lively  discussion  as  late  as  the  seventeenth  century. 

Of  physiology  in  the  works  of  Hippocrates  it  is  not 
easy  to  speak  with  propriety.  Still  the  facts  may  be  ad- 
'duced  that  it  was  assumed  the  food  was  cooked  in  the 
stomach,  which  possessed  a  peculiar  warmth,  increased  by 


THE    GREEKS  133 

the  liver ;  that  the  blood  is  "warm"  in  the  left  heart,  while 
in  the  right  it  is  still  "cold" ;  that  the  cause  of  its  warmth 
is  the  pneuma,  received  from  the  air  by  means  of  the 
"cold"  lungs.  Hippocrates'  profound  comprehension  and 
appreciation  of  the  history  of  medicine  is  expressed  in  the 
following  maxim: 

"The  physician  must  know  what  his  predecessors 
have  known,  if  he  does  not  wish  to  deceive  both  him- 
self and  others." 

The  undying  importance  of  Hippocrates  in  medicine 
rests,  first  of  all,  not  so  much  upon  his  enrichment  of  sci- 
ence with  new  material  (though  this  honor  too  is  his 
unquestioned  due)  as  upon  the  creation  of  a  scientific 
medicine  and  art;  upon  the  method  and  really  great  prin- 
ciples which  he  introduced  for  all  time  into  science  and 
especially  into  practice.  His  investigation  and  determina- 
tion of  the  phenomena  of  disease  and  of  the  science  of 
etiology,  and  still  more  his  improvement  of  professional 
treatment,  have  also  won  for  him  immortal  reputation. 

Hippocrates  was  above  all  else  a  practitioner  who  de- 
sired chiefly  not  to  impose  upon  his  fellow-men  with 
showy  discoveries  and  theories,  but  to  assist  them  to  the 
utmost  of  his  power.  And  this  he  did.  Hence  his  words 
of  immemorial  value: 

"Where  is  love  for  art,  there  is  also  love  toward 
man." 

This  maxim  alone  would  raise  him  to  that  genuine 
humanity  often  ascribed  to  Christianity  alone. 

The  great  philosopher  Plato  (429  B.  c.),  perhaps  one 
of  the  loftiest  intellects  the  world  has  ever  seen,  and  who 
illumined  with  his  clear-sighted  logic  every  subject  he 
touched,  treated  in  his  philosophy  certain  points  which 
had  a  distinct  influence  on  medical  thought  for  centuries 
to  come.  He  taught  that  the  heart  is  the  origin  of  the 
blood  vessels,  and,  as  the  seat  of  the  mind,  receives  through 
them  the  commands  of  the  superior  soul.  The  lungs,  which 


134  MEDICINE 

receive  through  the  trachea  a  portion  of  the  drink  in  addi- 
tion to  the  air,  serve  to  cool  off  the  heart.  The  liver  serves 
the  lower  desires  and  is  for  the  purpose  of  divination.  The 
spleen  furnishes  an  abode  for  the  impurities  of  the  blood. 
The  intestine  is  long  and  tortuous,  in  order  that  the  food 
may  remain  the  longer  therein,  so  that  the  mind  may  not 
be  disturbed  too  often  in  its  contemplation  by  the  renewal 
of  nutriment  necessitated  frequently  by  greater  shortness 
of  the  gut. 

Breathing,  he  declared,  takes  place  by  inward  pressure 
of  the  air,  for  no  vacant  space  can  exist  in  the  body.  The 
muscles,  with  the  bones,  serve  as  a  protection  to  the  mar- 
row against  the  heat  and  cold.  The  marrow  itself  consists 
of  triangles,  and  its  most  perfect  portion  is  the  brain. 
Death  is  occasioned  by  a  separation  of  the  soul  from  the 
marrow.  Sight  originates  in  a  union  of  the  light  flowing 
out  of  and  into  the  eyes ;  hearing  in  a  shock  of  the  air 
(correct  even  now),  which  is  communicated  to  the  brain 
and  the  blood  and  even  to  the  soul.  Taste  is  due  to  a  solu- 
tion of  rapid  atoms  by  means  of  small  vessels,  which  latter 
conduct  these  from  the  tongue  to  the  heart  and  soul ;  smell, 
however,  possesses  no  image  as  its  foundation  and  is  there- 
fore very  transitory. 

Disease,  he  thought,  originated  in  a  disturbance  of  both 
the  quantity  and  quality  of  the  fluids.  The  most  frequent 
cause  of  disease  is  the  downflow  of  mucus  and  acridity; 
the  most  dangerous  is  corruption  of  the  marrow.  Another 
cause  is  the  yellow  and  black  bile,  through  whose  aberra- 
tions inflammations  arise.  Continued  fever  is  occasioned 
by  fire,  quotidian  fever  by  air,  tertian  fever  by  water,  quar- 
tan fever  by  earth.  Mental  diseases  are  the  result  of 
corporeal  evils  or  of  bad  education.  Besides  bodily  exer- 
cise and  diet,  remedies  are  formed  from  drugs,  which 
constitute  an  opposing  treatment  for  diseases,  before  which 
they  flee  away.  Of  physicians  he  says  that  they  must  be 
rulers  of  the  sick,  in  order  to  cure  them,  but  they  must 
not  be  money-makers. 


THE    GREEKS  135 

Praxagoras  has  acquired  immortal  fame  by  his  discov- 
ery of  the  distinction  between  arteries  and  veins,  of  which 
the  former  were  the  active  agents  in  the  formation  of  the 
pulse.  He  thought,  under  ordinary  circumstances,  they 
contain  air  only,  but  in  the  case  of  wounds  blood  is  also 
found  in  them,  having  been  drawn  in  from  all  the  sur- 
rounding parts.  He  considered  respiration  an  action  de- 
signed to  strengthen  the  heart  by  forcing  air  into  that 
organ;  the  brain  was  a  mere  dependence  of  the  spinal 
cord,  but  the  heart  was  the  origin  of  the  nerves.  Prax- 
agoras was  a  "humorist"  of  the  purest  water,  and  as  such 
assumed  no  less  than  eleven  humors :  the  sweet,  acid,  salt, 
bitter  and  pungent  among  them.  He  sought  the  source  of 
fever  in  the  great  vena  cava,  and  called  attention  to  the 
differences  of  the  pulse  in  conditions  of  health  and  disease. 
He  practised  taxis  in  every  possible  way  in  cases  -of  stran- 
gulated hernia  and  even  performed  the  operations  of  herni- 
otomy  and  amputation  "of  the  soft  palate  when  diseased. 
In  therapeutics  he  favored  bleeding,  though  only  before 
the  fifth  day  in  inflammation,  employed  vegetable  remedies 
almost  exclusively  and  laid  great  weight  on  the  diet. 

Plato's  greatest  disciple  was  Aristotle  (384  B.  c.),  who 
was — and  indeed  still  is — an  oracle  in  philosophy  and  in 
certain  earlier  elements  of  natural  science.  Having  been 
given  eight  hundred  talents  (an  enormous  sum)  for  the 
collection  of  materials  for  a  "history  of  animals,"  he  ex- 
pended it  so  wisely  that  he  gathered  into  his  own  hands 
almost  every  item  of  information  possessed  by  the  ancient 
world.  In  advancing  the  knowledge  of  Nature  and  insist- 
ing on  the  exactitude  of  observations,  he  did  more  for 
medicine  than  even  his  master  Plato.  He  assumed  five 
elements  as  the  component  parts  of  the  body  and  assigned 
to  them  three  cardinal  qualities :  form,  substance  and 
motion  or  rest.  Experience,  he  taught,  was  the  basis  of 
all  science ;  the  body  is  the  instrument  of  the  soul,  and  both 
body  and  soul  are  in  essence  one  and  the  same.  Life  is 


136  MEDICINE 

movement;  the  heart,  however,  is  the  seat  of  warmth,  the 
source  of  motion,  sensibility  and  desire.  It  is  the  "Acropo- 
lis of  the  body." 

The  investigation  of  Aristotle  in  natural  science  ex- 
tended especially  over  the  animal  kingdom.  He  was  a 
famous  zoologist  and  the  founder  of  Comparative  An- 
atomy. It  is  only  through  Physiology  that  he  comes  into 
contact  with  medicine,  since  pathology,  particularly  that 
of  man,  is  only  slightly  and  incidentally  considered.  He 
refers  diseases  to  the  blood  and  the  humors,  through  the 
abundance  or  lack  of  which,  as  the  case  may  be,  their  dif- 
ference arise.  He  made  observations  on  the  influence  of 
the  weather,  the  season,  the  food,  drugs,  etc. 

On  the  other  hand,  his  labors  in  Anatomy,  .which  he 
studied  in  animals,  are  of  great  importance.  He  distin- 
guished the  nerves  as  such,  but  called  them  canals  of  the 
brain,  which  latter  organ  he  described  as  bloodless  and  of 
the  largest  size  in  man.  Yet  by  the  term  "neura"  he 
understands  tendons  and  ligaments,  which  he  thinks  origi- 
nate from  the  heart.  He  recognized  the  optic  nerve,  but 
explained  the  auditory  nerve  as  a  "vessel." 

The  common  origin  of  the  vessels  from  the  heart  is  also 
one  of  his  theses,  and  he  discovered  independently  the  dif- 
ference between  arteries  and  veins.  He  gave  its  name  to 
the  aorta  and  speaks  of  the  great  vena  cava.  Yet  he  had 
totally  incorrect  views  concerning  the  course  of  the  vessels. 
Thus  one  ran  from  the  liver  to  the  right  arm,  another  from 
the  spleen  to  the  left  arm ;  hence  venesection  upon  the  side 
of  the  organ  affected  by  disease  was  especially  efficacious. 
He  described  the  ureter  correctly  and  the  organs  of  sen- 
sation inexactly. 

In  his  Physiology  he  assumes  that  vessels  and  tendons 
preside  over  sensation.  Chyle  originates  in  the  process  of 
coction  in  the  stomach  and  is  thence  carried  into  the  heart. 
In  his  view  the  blood  is  the  nutritive  material  designed  for 
the  formation,  growth  and  warming  of  the  body  and  for  the 
supply  of  its  waste.  It  is  brought  to  the  tissues  by  the 


THE    GREEKS  137 

vessels  and  in  its  normal  condition  is  an  indifferent  fluid 
which  contains  neither  mucus,  bile  nor  water.  But  in  con- 
ditions of  disease  the  blood  becomes  mixed  with  these 
extraneous  fluids.  Sleep  is  a  restrained  energy  of  sensa- 
tion, with  unrestrained  capacity  therefor.  In  respiration 
the  pneuma,  which  serves  for  the  purpose  of  cooling, 
passes  through  the  trachea  into  the  heart. 

Aristotle  emphasizes  the  necessity  and  advantage  to  the 
physician  of  a  knowledge  of  the  natural  sciences.  He 
says: 

"It  is  the  business  of  the  naturalist  to  know  also  the 

causes  of  health  and  disease.     Hence  most  naturalists 

see  in  medicine  the  conclusion  of  their  studies,  and  of 

physicians,  those  at  least  who  display  some  scientific 

knowledge  in  the  practice  of  their  art,  begin  the  study 

of  medicine  with  the  natural  sciences." 

He  also  emphasizes  the   fact  that  the  better  class  of 

physicians  lay  great  weight  upon  anatomy.     Yet  in  spite 

of  his  nice  knowledge  of  Nature,  Aristotle  was  not  free 

from  the  superstition  of  his  age  and  was  a  believer  in 

dreams,  the  happy  significance  of  a  sneeze,  chiromancy  and 

similar  matters  which  are  now  set  aside. 

The  school  of  Alexandria  (300  B.  c.)  presented  an  en- 
tirely new  aspect  to  the  ancient  world.  The  science  of 
medicine  was  cultivated  in  this  school  with  great  zeal,  and 
some  improvements  are  due  to  its  professors.  Among  the 
most  famous  of  these  are  Erisistratus  and  Herophilus. 
Little  detail  is  handed  down  about  them,  but  they  are  par- 
ticularly mentioned  as  being  the  first  who  dissected  the 
human  body,  for  which  purpose  the  bodies  of  criminals 
were  allotted  to  them  by  the  government.  They  pointed 
out  the  difference  between  the  structure  of  the  human  body 
and  that  of  animals  which  most  resembled  it.  They  ascer- 
tained more  correctly  the  structure  of  the  heart  and  great 
vessels  and  of  the  brain  and  nerves. 

Soon  after  the  establishment  of  the  Alexandrian  school 


138  MEDICINE 

the  medical  profession  became  divided  on  the  method  of 
treatment  and  study  of  disease — the  Dogmatists  and  later 
the  Empirics.  The  Dogmatic  school  professed  to  set  out 
with  theoretical  principles  which  were  derived  from  the 
generalization  of  facts  and  observations  and  to  make  these 
principles  the  basis  of  practice.  Although  this  is  now  con- 
sidered the  correct  method  to  pursue  the  study  and  practice 
of  medicine,  it  is  a  method  which  if  not  carefully  watched 
is  exposed  to  the  greatest  danger  of  being  corrupted  by 
ignorance  and  presumption.  This  occasioned  the  slow  for- 
mation of  the  opposing  sect — the  Empirics — who  defended 
the  principle  of  'experience'  as  being  of  chief  importance 
in  the  development  of  the  methods  of  medical  investigation 
and  treatment.  The  Empirics  rejected  as  useless  all  search 
after  the  theoretical  causes  of  disease  and  all  knowledge  of 
anatomy — certainly  a  grave  mistake — but,  on  the  other 
hand,  in  their  emphasis  on  experience  caused  the  formation 
of  the  conception  of  the  physician,  not  only  as  a  scholar 
and  a  student,  but  also  as  a  man  of  ripe  judgment  and 
understanding. 


CHAPTER  III 

THE  ROMANS 

FOR  some  centuries  the  Alexandrian  school  first  con- 
tributed to  the  advance  of  all  sciences  and  then  prevented 
a  too  early  decay  of  them.  The  Grecian  civilization  had 
begun  to  decline,  and  it  was  during  this  time  that  the 
Roman  Empire  laid  the  foundation  for  its  future  grandeur. 
The  martial  character  of  Roman  life  drew  the  attention 
away  from  medicine.  "The  Roman  people,"  says  Baas, 
"for  more  than  six  hundred  years  were  not,  indeed,  with- 
out medical  art,  but  they  were  without  physicians." 

This  art  consisted  merely  in  prayers,  dietetic  measures, 
prescriptions  from  the  Sibylline  books,  charms,  etc.  That 
the  Romans  cherished  much  grosser  superstitions  than  the 
Greeks  is  well  known.  With  rude  simplicity  they  elevated 
into  divinities  those  evils  which  especially  harassed  them 
and  then  in  the  early  centuries  of  Rome  worshiped  these 
deities  with  fervor.  Later  Romans  became  dissatisfied 
with  their  own  gods  and  worshiped  also  Phrygian,  Egyp- 
tian and  Grecian  medical  gods  and  built  for  them  temples 
at  Rome  and  in  other  places. 

A  Roman  of  natural  talents,  educated  at  Alexandria,  ac- 
quainted with  human  nature  and  possessed  of  considerable 
shrewdness  and  address  was  Asclepiades  (100  B.C.),  but  he 
possessed  little  science  or  professional  skill.  He  began  by 
villifying  the  principles  and  practices  of  his  predecessors, 
especially  Hippocrates,  and  asserted  that  he  had  discovered 
the  most  perfect  and  efficient  form  of  treating  diseases. 


140  MEDICINE 

He  conceived  matter  to  consist  of  extremely  small  atoms,1 
cognizable  indeed  by  the  understanding  but  not  by  the 
senses. 

Between  the  particles  of  the  atom  he  suggested  little 
empty  tubes,  the  'poroi,'  in  which  move  a  multitude  of  the 
finest  particles  which  occasion  sensation  and  correspond 
to  the  pneuma  of  others,  here  considered  only  atomically. 
If  the  motion  of  these  particles  is  quiet  and  regular,  it  is 
called  health,  but  if  it  is  irregular,  feeble  or  boisterous, 
sickness  arises.  Sickness  also  originates  in  the  air  re- 
ceived in  respiration  and  in  the  food  and  enters  the  body 
in  respiration  and  digestion,  by  both  of  which  it  passes 
through  the  'poroi'  into  the  heart  and  the  blood  and  through 
this  finally  into  the  whole  body  which  it  nourishes.  The 
pulse  originates  in  an  influx  of  the  particles  into  the  ves- 
sels; animal  heat,  sensation,  secretion  in  a  similar  way; 
hunger  and  thirst,  however,  originate  in  emptiness  of  the 
pores  of  the  stomach,  which,  in  accordance  with  varying 
conditions,  may  be  either  empty,  full  or  contracted.  Ac- 
cording to  him,  the  proximate  cause  of  disease  is  stagna- 
tion of  the  atoms;  on  the  other  hand,  he  finds  in  the 
humors  only  a  secondary  cause. 

In  surgery  Asclepiades  has  won  great  reputation  by  his 
practice  of  tracheotomy  in  angina.  He  also  recommended 
scarification  of  the  ankles  in  dropsy,  as  well  as  paracen- 
tesis  with  the  smallest  possible  wound.  He  observed,  too, 
spontaneous  dislocation  of  the  hip-joint. 

In  pathology  he  was  the  first  to  distinguish  definitely 
acute  and  chronic  diseases  (for  example  dropsy).  The 
special  forms  of  diseases  are  based  upon  the  greater  or 
less  disproportion  of  the  atoms  to  the  'poroi'  and  the  grade 
of  stagnation  thus  occasioned.  Thus,  he  said,  quotidian 
fever  originates  through  the  largest  atoms,  tertian  through 
the  medium-sized,  quartan  through  the  finest. 

Upon  the  size  of  these  atoms  depends  also  the  grade  of 
the  fever;  larger  atoms  occasion  severe,  smaller  less  dan- 
gerous fever.  Fever  heat  originates  in  active  movements 


THE  ROMANS  141 

of  the  atoms;  the  dullness  is  due  to  their  quiescence. 
Hemorrhage  is  a  result  of  putridity  or  of  laceration. 
Crises,  in  opposition  to  Hippocrates,  Asclepiades  totally 
denied,  a  denial  which  excited  the  special  wrath  of  Galen. 
What  is  said  in  therapeutics  of  the  activity  of  nature  is, 
according  to  Asclepiades,  pure  sophistry.  The  physician 
alone  cures  and  nature  simply  supplies  opportunities. 

Those  who  followed  Asclepiades  formed  a  new  school, 
called  Methodism,  which  stood  for  a  course  midway  be- 
tween Dogmatism  and  Empiricism.  The  theory  was  that 
the  solids  are  the  seat  and  cause  of  disease,  in  this  respect 
directly  opposite  to  that  of  Hippocrates,  who  traced  cause 
of  disease  to  a  disturbance  of  the  fluids,  the  so-called 
humoral  pathology. 

The  most  important  Roman  author  on  medical  subjects 
and  a  compiler  of  a  very  high  order  in  his  eight  books, 
"De  Medicina,"  was  Aulus  Cornelius  Celsus  (between 
25-30  B.C.  and  45-50  A.D.).  He  had  also  written  on  phi- 
losophy, oratory,  jurisprudence  and  history  and  was  in 
fact  an  encyclopedist.  Tho  not  a  physician  by  profession, 
he  thought  and  wrote  on  medicine  as  tho  he  were  a  practi- 
tioner, so  that  his  work  may  claim  the  value  of  an  original 
treatise  on  medicine. 

His  descriptive  and  operative  surgery  (including  also 
operative  dentistry)  is  considered  his  best  contribution  to 
medical  art.  It  must  still  be  regarded  as  a  "masculine" 
branch  in  comparison  with  the  salve-surgery  which  came 
into  vogue  at  a  later  period.  It  gives  also  the  best  idea  of 
the  eminent  services  of  the  Alexandrians,  who  furnished 
the  substance  of  surgical  art. 

He  was  the  first  writer  who  professedly  treats  of  sur- 
,gery  and  its  operations,  and  he  shows  that  the  art  had  at- 
tained an  astonishing  degree  of  perfection.  The  state  of 
surgery  in  his  time  must  have  been  much  further  ad- 
vanced than  medicine. 

He  describes,  on  the  one  hand,  a  large  number  of  surgi- 
cal ailments,  such  as  diseases  of  the  joints  and  the  bones, 


142  MEDICINE 

wounds,  tumors,  burns,  fistula,  abscess,  sprains  and  luxa- 
tions, for  which  he  recommends  reduction  before  the  de- 
velopment of  inflammation ;  fractures,  in  which,  when  they 
fail  to  unite,  he  recommends  extension  and  rubbing  together 
the  ends  of  the  bone  and  even  cutting  down  upon  the  bone 
so  that  it  heals  as  an  open  wound ;  hernia,  which  he  thinks 
originates  in  laceration  of  the  peritoneum;  strangulated 
hernia,  where  he  cautions  against  cathartics;  the  radical 
operation  for  reducible  hernia ;  foreign  bodies  in  the  ears, 
etc.  On  the  other  hand,  he  notices  many  operations  of 
the  ancients,  some  of  them  handed  down  by  him  alone, 
among  others,  bleeding,  double  ligation  of  bleeding  vessels 
and  division  of  the  vessels  between  the  ligatures. 

In  this  work  of  Celsus  much  of  the  substance  of  the  lost 
writings  of  ancient  physicians,  and  especially  those  of  the 
Alexandrian  age,  is  preserved.  He  has  manifestly  selected 
from  these  with  ripe  judgment  only  what  is  reasonable, 
useful  and  valuable,  and  accordingly  has  paid  compara- 
tively little  attention  to  opinions  and  theories,  a  point  in 
which  he  contrasts  strongly  with  Galen,  and  which  im- 
presses upon  his  work  the  stamp  of  practicality  and  use- 
fulness. 

Celsus  is  the  first  native  Roman  physician  whose  name 
has  been  transmitted.  Before  his  time  all  those  who 
arrived  at  any  degree  of  eminence  were  either  Greeks  of 
Asiatics,  thus  suggesting  the  idea  that  most  native  practi- 
tioners were  of  humble  rank.  This  may  be  attributed  to 
the  low  state  of  science  in  Rome,  altho  literature  had  ad- 
vanced to  a  high  state.  All  trades  and  manufactures  of 
Rome  were  carried  on  by  slaves,  and  medicine  seems  to 
have  been  placed  in  the  same  class. 

In  opposition  to  the  humoral  theory  of  the  "Dogmatists" 
and  the  solidism  of  the  "Methodists,"  the  Pneumatic  school 
introduced  the  aeriform,  spiritual  principle  of  the  "pneuma" 
(the  world-soul  of  the  Stoics),  into  their  general  pathology. 
Yet  they  also  left  the  elementary  qualities  (warmth,  cold- 
ness, moisture  and  dryness,  which  according  to  their  doc- 


THE  ROMANS  143 

trine  may  be  seen  and  felt  and  not  recognized  simply  by 
their  effects)  a  place  in  their  "system."  The  pneuma 
conies  by  way  of  the  respiration  as  a  part  of  the  creative 
"world-sour*  into  the  heart  and  is  driven  thence  into  the 
vessels  and  the  whole  body,  in  which  it  effects  in  a  passive 
way  the  diastole  of  the  pulse,  while  the  contraction  of  the 
arteries  is  an  active  process.  When  it  works  regularly  and 
is  united  with  warmth  and  moisture  it  occasions  health; 
under  contrary  circumstances,  and  mixed  with  warmth 
and  dryness,  it  occasions  the  acute  diseases,  while  mixed 
with  cold  and  dryness  melancholy.  This  latter  condition 
in  its  acme  introduces  death,  a  state  in  which  everything 
becomes  dry  and  cold. 

Areteus  of  Cappadocia  (about  30-90  A.D.)  shows  him- 
self a  great  physician  by  his  conception,  even  thus  early, 
of  the  duties  of  his  profession.  He  was  one  of  the  Pneu- 
matic school  and  an  eminent  medical  writer. 

In  anatomy  he  does  not  differ  greatly  from  the  views 
of  his  time.  Still  in  his  work  are  found  intimations  of  the 
tubes  of  Bellini,  while  he  may  have  had  a  correct  idea 
of  the  decussation  of  the  nerves  in  the  medulla.  He 
knew  that  the  tongue  was  composed  of  muscles.  In  physi- 
ology he,  with  Aristotle,  regarded  respiration  as  the  proc- 
ess by  which  the  pneuma  reached  the  lungs  and  thence 
the  heart,  the  seat  of  life.  The  blood  was  prepared  in  the 
liver,  the  bile  in  the  gall-bladder;  in  the  large  intestine  a 
secondary  digestion  takes  place;  in  the  spleen  is  to  be 
found  thick,  coagulated  blood;  the  seat  of  the  soul  is  in 
the  heart.  He  knew  that  the  contents  of  the  arteries  was 
light-colored,  that  of  the  veins  dark. 

Rufus  of  Ephesus  (about  50  A.D.),  who  lived  shortly 
after  Celsus,  practiced  dissection  on  apes  and  other  of  the 
lower  animals.  He  discovered  the  decussation  of  the  optic 
nerves  and  the  capsule  of  the  crystalline  lens  and  gave,  for 
the  time,  a  very  clear  description  of  the  membranes  and 
parts  of  the  eye.  He  taught  that  the  nerves  originated 
from  the  brain.  Physiologically  he  divided  them  into 


144  MEDICINE 

nerves  of  motion  and  nerves  of  sensation  and  ascribed  to 
them  all  the  functions  of  the  body,  since  he  did  not  distin- 
guish them  accurately  from  muscles  and  tendons.  The 
heart,  whose  left  cavity  he  declares  to  be  thinner  and 
smaller  than  the  right,  he  considers  the  organ  which  gives 
origin  to  the  pulse,  and  he  associates  the  latter  also  with 
the  pneuma.  He  describes  the  pulse  carefully  in  its  vari- 


Fig.  4 — SURGERY,  PHARMACY,  MEDICINE,  FIRST  DIVIDED 

eties  as  dicrotic,  suppressed,  innumerable  and  intermittent. 
The  heart  is,  in  his  view,  the  seat  of  life  and  of  animal 
heat,  while  the  spleen  is  a  useless  organ.  He  was  also  an 
alienist  and  wrote  on  the  subject  of  melancholia.  A  sick 
man  who  believed  that  he  had  no  head  was  convinced  of 
its  existence  by  a  leaden  hat.  Moreover,  he  studied  dis- 
eases of  the  urinary  bladder  and  kidneys  and  medicines — 
the  latter  of  which  he  discussed  in  verse. 


THE  ROMANS  145 

The  Eclectic  school  was  founded  90  A.DV  the  main  prin- 
ciples being  to  avoid  theories  and  metaphysical  specula- 
tions and  to  select  from  all  preceding  schools  that  which 
was  most  reasonable  and  practically  beneficial.  The  most 
famous  man  of  this  sect  was  Claudius  Galen  (131-204  A.D.), 
one  of  the  most  remarkable  men  in  the  whole  history  of 
Medicine.  He  made  his  influence  felt  both  in  his  time  and 
for  centuries  to  come.  He  enjoyed  a  most  thoro  education 
at  home  and  abroad ;  he  studied  at  Alexandria  and  traveled 
extensively;  he  knew  all  the  teachings  of  his  predecessors 
and  he  wrote  an  immense  number  of  medical  treatises.  At 
once  he  attained  first  rank  in  medicine,  and  this  rank  has 
been  compared  not  unaptly  to  that  which  Aristotle  pos- 
sessed in  the  world  of  general  science.  For  centuries  after 
his  death  his  doctrines  and  tenets  were  regarded  almost  in 
the  light  of  oracles  which  very  few  had  the  audacity  and 
courage  to  oppose.  And  it  may  be  stated  without  exagger- 
ation that  the  authority  of  Galen  alone  was  estimated  at  a 
much  higher  rate  than  that  of  all  other  medical  writers 
combined,  extending  over  a  period  of  twelve  hundred 
years. 

That  he  was  a  man  of  wonderful  intellect  and  great  tal- 
ents no  one  can  deny.  He  had  studied  philosophy  very 
thoroly,  and  as  was  the  tendency  in  those  days,  this  was 
intimately  interwoven  with  his  medical  beliefs.  He  was 
an  admirer  of  Hippocrates  and  always  speaks  of  him  with 
great  respect,  professing  to  act  on  his  principles.  Yet,  as 
a  matter  of  fact,  the  two  men  could  not  be  more  different, 
the  simplicity  of  the  ancient  Greek  being  strongly  con- 
trasted with  the  abstruseness  and  refinement  of  Galen. 

The  general  pathological  views  of  Galen  are  founded 
upon  the  four  elements  to  which  are  attached  the  primary 
qualities :  To  air  coldness,  to  fire  warmth,  to  water  moist- 
ure, to  earth  dryness.  To  these  correspond  four  cardinal 
humors,  among  which  latter  the  element  water  predomi- 
nates in  the  mucus,  which  is  secreted  by  the  brain;  fire  in 
the  yellow  bile,  which  has  its  origin  in  the  liver;  earth  in 


146  .MEDICINE 

the  black  bile  formed  by  the  spleen,  while  in  the  bloo'd, 
which  is  prepareii  in  the  liver  (an  important  error  not  dis- 
carded until  the  seventeenth  century),  the  elements  are 
uniformly  mixed.  Mucus  is  cold  and  moist,  yellow  bile 
warm  and  dry,  black  bile  cold  and  dry,  the  blood  warm  and 
moist. 

The  life-giving  principle  is  the  soul,  which  as  "spiritus," 
or  "pneuma,"  is  taken  from  and  constantly  renewed  by 
the  general  world-soul  in  the  respiration.  Arrived  in  the 
body,  the  pneuma  becomes  in  the  brain  (to  which  it  pene- 
trates through  the  nose)  and  in  the  nerves  the  "animal  spir- 
its"; in  the  arteries  and  the  heart  (to  which  it  comes  by 
way  of  the  lungs)  the  "vital  spirits/'  and  in  the  liver  and 
the  renal  veins  the  "natural  spirits."  The  three  funda- 
mental faculties,  the  "animal,"  "vital"  and  "natural," 
which  bring  into  action  and  keep  in  operation  the  corre- 
sponding functions,  originate  as  an  expression  of  the 
primal  force  "soul"  (pneuma),  existing  in  these  three 
faculties  within  the  body.  Besides  these,  there  are  for 
special  functions  of  the  body  other  faculties,  subordinate 
to  these  three  and  acting  occasionally  as  the  "attractive," 
the  "propulsive,"  the  "retentive"  and  the  "secreting." 

Upon  these  depend  nutrition,  assimilation,  secretion, 
muscular  contraction,  in  general  all  the  ordinary  functions 
of  the  body,  in  which  each  organ  has  the  property  of  appro- 
priating to  itself,  by  means  of  these  faculties,  that  which 
is  necessary  for  its  own  existence.  There  are,  besides 
these,  "special  forces,"  which  are  not  derived  from  the 
three  already  named,  and  which  are  therefore  supernatural. 
Everything,  however,  which  exists  and  displays  activity 
in  the  human  body  originates  in  and  is  formed  upon  an 
intelligent  plan,  so  that  the  organ  in  structure  and  func- 
tions is  the  result  of  that  plan.  Thus  the  human  frame  is 
adapted  to  the  solution  of  a  teleological  problem.  Indeed 
Galen  is  the  father  of  teleology  in  medicine. 

Galen  is  of  peculiar  importance  in  special  pathology 
from  the  fact  that  he  first  designedly  employed  experiment 


THE  ROMANS  147 

for  its  basis.  He  was  the  first  physiologist  (if  we  except 
the  accounts  of  the  Hippocratists  in  embryology)  to  ex- 
periment and  vivisect  upon  scientific  principles  and 
founded  the  physiology  of  the  nervous  system.  Nerves  of 
motion,  which  as  such  are  "hard,"  are  represented  by  the 
sixty  spinal  nerves;  those  of  sensation  ("soft")  by  the 
nerves  of  the  brain.  Of  the  latter  he  recognized  seven. 
Galen  was  acquainted  with  the  movement  of  the  brain 
and  assumed  that  by  it  the  impurities  of  the  "animal  spir- 
its," brought  to  the  brain  by  the  carotids,  were  then  ex- 
pelled, while  its  more  refined  portions,  the  nervous  spirits, 
were  prepared  in  the  plexus  of  the  ventricles  and  thence 
borne  by  the  nerves  thruout  the  body.  The  great  sensibil- 
ity of  the  intestines  depends  upon  the  sympathetic  nerve. 
The  perception  of  light  he  locates  in  the  retina. 

Respiration  and  the  pulse  serve  one  purpose — the  recep- 
tion of  air.  The  latter  in  inspiration  comes  first  into  the 
lungs  and  thence  into  the  left  heart  and  arteries.  On  the 
other  hand,  during  the  diastole,  or  rest  of  the  arter- 
ies, air  is  sucked  into  them  through  the  pores  of  the  skin. 
During  the  systole,  or  contraction  of  the  lungs  and  ar- 
teries, the  "soot"  escapes.  The  air  or  pneuma  received  by 
the  lungs  is  not  sufficient  by  itself  to  cool  the  heart,  hence 
air  is  also  received  through  the  skin.  The  diastole  of  the 
heart  and  arteries  and  inspiration  also  conduct  pneuma  to 
the  blood,  while  the  systole  and  expiration  discharge  the 
"soot"  from  the  blood.  Respiration  has  its  origin  in  the 
vital,  the  pulse  in  the  animal  sphere.  Respiration  is  ef- 
fected by  means  of  the  diaphragm  and  the  intercostal 
muscles. 

The  physiological  route  of  the  pneuma  (the  respiratory 
process  he  deemed  one  of  combustion)  is  developed  within 
the  body  or  the  vessels  as  the  circulation,  which  takes 
place  as  follows :  From  the  stomach  the  food,  which  has 
undergone  "coction,"  proceeds  to  the  liver,  where  it  is 
converted  into  blood.  This  blootj  is  now  carried  to  the 
heart,  and  the  latter  organ  (whose  various  parts  all  con- 


148  MEDICINE 

tract  simultaneously)  drives  into  the  lungs,  through  the  pul- 
monary artery,  so  much  of  this  blood  as  may  be  required 
for  their  nutrition.  At  the  same  time  the  remainder  of  the 
blood  is  driven  through  the  veins  into  the  body  and  a  minute 
portion  passes  through  the  pores  of  the  septum  into  the  left 
ventricle,  where  it  is  mixed  with  the  pneuma  drawn  into 
the  heart  through  the  pulmonary  veins  in  diastole.  No  blood 
returns  from  the  lungs  to  the  heart,  for  all  of  it  is  con- 
sumed in  the  nutrition  of  those  organs.  From  the  left 
heart  the  blood  (mixed  with  the  pneuma)  proceeds  through 
the  aorta,  to  be  communicated  to  the  veins  finally  by  means 
of  the  pore-like  anastomoses  at  the  terminations  of  this 
vessel.  To  the  veins  all  the  nutrition  of  the  body  is  due. 

The  blood  conveyed  to  the  body  by  the  veins  is  princi- 
pally used  up  in  nutrition,  but  what  little  remains,  together 
with  the  new  blood  formed  in  the  liver,  returns  to  the 
right  heart  by  a  sort  of  ebb-tide  in  the  venous  circulation. 
Dilatation  and  diastole  of  the  heart,  as  well  as  of  the 
arteries,  are  the  active  factors  in  the  motion  of  these  parts, 
while  systole  is  the  passive  element.  (Systole  is  really  the 
active  heart-muscle.)  Singularly  enough,  however,  no 
physician,  down  to  the  time  of  Harvey,  formed  a  similar 
opinion  of  the  theory  of  circulation  of  the  ancients.  The 
blood  is  perfected  in  the  heart  and  supplied  with  the  'cali- 
dum  innatum'  (innate  heat)  and  then  passes  on  into  the 
body.  The  pulse  arises  from  an  active  dilating  force, 
pulse-force,  communicated  to  the  arteries  from  the  heart. 

The  heart  has  no  nerves,  but  is  the  seat  of  passion  and 
courage.  The  brain  is  the  seat  of  the  rational  soul  and 
an  organ  for  the  secretion  of  mucus  and  for  cooling  the 
heart.  The  lungs  also  serve  to  cool  off  the  heart.  The 
liver  is  the  place  for  the  preparation  of  the  blood  and  the 
seat  of  love.  The  "animal  spirits"  are  the  cause  of  the 
soul's  activity.  They  originate  from  the  blood,  but  in  the 
brain  become  the  "animal  spirits."  From  the  origin  of  the 
"animal  spirits"  the  dependence  of  mental  expressions  and 
disturbances  upon  the  bodily  condition  is  also  explained. 


THE  ROMANS  149 

Galen  divided  these  mental  disturbances  into  mania, 
melancholia,  imbecility  and  dementia. 

In  direct  opposition  to  what  had  been  said  concerning 
mental  activity  and  its  cause  and  seat,  he  explains  the  tem- 
peraments by  the  mixture  of  the  elements,  and  therefore 
divides  them  into  (i)  the  dry  and  warm  (choleric)  ;  (2) 
dry  and  cold  (melancholic)  ;  (3)  moist  and  warm  (san- 
guine) ;  (4)  moist  and  cold  (phlegmatic).  The  sensations 
again  are  dependent  upon  the  animal  spirits.  The  sight  is 
effected  through  that  portion  of  these  spirits  which  is  found 
between  the  lens  and  the  choroid  and  which  intercepts  the 
rays  of  light  in  order  to  conduct  them  to  the  optic  nerve. 
The  pneuma  likewise  occasions  the  smell  by  forcing  its 
way  into  the  anterior  ventricles  of  the  brain,  which  are 
the  seat  of  this  sense.  The  hearing  originates  in  the  pene- 
tration of  the  pneuma,  in  the  form  of  waves,  into  the 
course  of  the  nerve  of  hearing. 

Much  more  original  is  the  knowledge  of  Galen  in  an- 
atomy, which  from  his  youth  up  he  studied  with  enduring 
fondness.  His  observations  were  confined  entirely  to  the 
lower  animals,  except  in  regard  to  the  bones,  which  he 
had  been  able  to  study  upon  two  human  skeletons  at  Alex- 
andria. One  of  these  skeletons  had  been  cleaned  by  birds, 
the  other  by  the  Nile,  and  Galen  considered  it  a  piece  of 
special  good  fortune  that  he  had  been  able  to  study  their 
structure.  His  anatomical  works— the  best  among  the 
ancients — continued  text-books  down  into  the  sixteenth 
century.  He  is  in  many  points  the  first  discoverer  and 
always  a  very  careful  describer,  the  latter  especially  in 
regard  to  osteology,  the  central  and  peripheral  nervous 
system,  the  larynx,  the  intestines  and  the  genital  organs, 
tho  he,  too,  is  not  free  from  the  confusion  and  errors  of 
the  ancients  and  readily  falls  into  teleological  speculations. 
He  handled  the  subject  of  bandaging  in  detail  and  intro- 
duced the  methods  known  even  to-day. 

Galen  did  not  greatly  advance  semeiology,  with  the  ex- 
ception of  the  doctrine  of  the  pulse,  which  he  elaborated 


150  MEDICINE 

so  extensively  that  he  wrote  many  treatises  on  this  sub- 
ject alone.  He  advanced  diagnosis  chiefly  by  his  sharper 
systematic  definition  of  the  phenomena  of  disease,  while, 
so  far  as  the  means  of  investigation  are  concerned,  he  did 
not  go  beyond  the  Hippocratists  and  earlier  physicians. 

In  special  pathology  Galen  added  little  of  importance  to 
the  material  already  existing,  tho  he  constructed  his  pic- 
tures of  disease  more  perfectly  through  a  better  analysis  of 
single  symptoms,  as  in  phthisis  (its  different  forms  and 
infectious  (?)  character),  pneumonia  and  pleuritis,  gout, 
rheumatism,  intermittent  fever,  varieties  of  spasm,  etc. 
Cancer  he  regards  as  a  parasitic  being,  which  occasions 
both  local  and  general  disturbances.  Rightly,  however, 
he  laid  great  weight  on  so-called  climatic  cures,  of 
which  he  seems  to  have  been  the  founder.  But  even  in 
the  treatment  of  disease  he  was  less  a  practitioner  than  a 
skilful  theorist. 

One  of  the  most  distinguished  surgeons  of  antiquity  was 
Antyllus,  the  first  who,  in  addition  to  depression,  described 
the  extraction  of  small  cataracts.  He  also  described  the 
so-called  Antyllic  method  of  operation  on  aneurism,  as 
well  as  the  method  of  practicing  venesection,  cupping, 
scarification,  arteriotomy,  subcutaneous  section  of  the  liga- 
ments in  stiff  joints  and  of  the  ligaments  of  the  tongue  in 
stammering. 

The  change  which  came  over  the  world  of  thought  with 
the  transference  of  the  capital  from  Rome  to  Constanti- 
nople was  not  without  its  effect  on  medicine,  and  from  the 
time  of  Antyllus  a  new  type  of  medical  art  is  made  evident. 
Naturally  the  Roman  period  followed  the  Greek  in  its 
much  philosophizing,  but  there  was  an  earnest  desire  to 
learn  and  what  was  known  was  practiced  simply  and  with- 
out the  desire  to  impress  the  beholders.  The  periods  to 
come  reveal  a  vast  change  in  the  attitude  of  the  medical 
profession  to  the  world,  the  classic  medical  philosopher 
disappearing  with  the  fall  of  Rome. 


CHAPTER  IV 

BYZANTINE   AND  ARABIAN   SCHOOLS 

WITH  the  removal  of  the  "Capital  of  the  World'*  from 
Rome  to  Constantinople  (Byzantium)  a  new  epoch  was 
opened  upon  the  world,  in  which  Medicine  shared.  Con- 
stantine  I.  (312-337),  the  first  Christian  emperor,  seemed 
to  feel  that  by  investigating  theological  claims  he  had 
secured  exemption  from  scientific  interest,  and  the  healing 
art  found  little  imperial  patronage.  Indeed,  the  times 
generally  seemed  to  be  satisfied  with  the  progress  that  had 
been  made  in  science,  and  after  the  death  of  Galen,  for 
many  years  there  are  no  illustrious  names,  and  no  dis- 
coveries worth  the  mentioning.  Literature  had  declined 
rapidly,  and  the  last  vestige  of  Roman  patriotism  passed 
away  when  the  empire  was  divided  into  an  East  and  a 
West.  Even  in  the  time  of  Galen,  the  Roman  Empire  had 
begun  to  decline,  and  altho  it  produced  a  very  few 
scientists,  most  of  the  illustrious  physicians  and  surgeons 
were  foreigners — either  Greeks  or  Asiatics.  But  during 
the  third  and  fourth  centuries  of  the  Christian  era,  no 
names  are  heard,  nothing  is  written — there  being  merely 
a  few  compilations  of  Galen  and  the  early  Greek  medicin- 
ers.  One  of  these  compilers,  perhaps  the  best,  was  Ori- 
basius,  who  at  the  request  of  the  Emperor  Julian,  made 
a  compilation  of  all  medical  works  from  the  time  of  Hip- 
pocrates to  Galen. 

The  city  of  Alexandria  still  retained  its  reputation  as  the 
great  school  of  medicine,  depending,  of  course,  on  its  ex- 


152  MEDICINE 

tensive  medical  library.  But  this  was  destroyed  by  the 
conquest  of  the  Arabians  in  the  seventh  century.  The 
Saracens,  in  a  spirit  of  blind  bigotry,  appeared  to  be 
actuated  by  the  barbarous  desire  to  eradicate  science  from 
the  face  of  the  earth.  However,  in  spite  of  the  Saracens, 
some  of  the  books  escaped  the  fire,  and  these  were  care- 
fully hidden  by  those  who  appreciated  their  value.  Among 
these  relics  were  the  writings  of  Galen,  and  in  an  early 
period  of  the  Saracenic  Empire,  they  began  to  be  held 
in  high  esteem.  This  period  extended  only  to  the  eighth 
century  and  was  merely  a  continuation  of  Galen's  won- 
derful influence.  The  physicians  did  not  advocate  science, 
merely  professing  to  comment  on  and  copy  from  the  works 
of  their  great  master. 

Aetius  (circa  510  A.D.)  occupied  in  Byzantium  al- 
most the  same  position  as  Oribasius  in  Rome.  He 
embraced  the  doctrines  of  the  Christian  religion,  and 
these  played  some  part  in  his  treatment  of  diseases.  In 
surgical  therapeutics,  Aetius  recommended  a  great  number 
of  salves  and  plasters.  The  preparation  of  salves  must, 
however,  take  place  with  certain  ceremonies.  Thus,  one 
should  continually  repeat,  in  a  loud  but  solemn  tone,  the 
charm  "The  God  of  Abraham,  the  God  of  Isaac,  the  God 
of  Jacob,  give  virtue  to  this  medicament,"  until  the  re- 
quired consistency  of  the  plaster  in  process  of  making  is 
obtained.  If  a  bone  is  stuck  in  the  throat,  the  patient 
should  swallow,  and  then  draw  out  again,  a  piece  of  raw 
meat,  to  which  a  pack-thread  has  been  fastened;  or  the 
physician  should  grasp  him  by  the  throat  (unfortunately 
the  results  of  this  treatment  are  not  given!)  and  cry  in  a 
loud  voice,  "As  Lazarus  was  drawn  from  the  grave  and 
Jonah  out  of  the  whale,  thus  Blasius,  the  martyr,  com- 
mands, 'Bone,  come  up  or  go  down !/  "  He  practiced  vene- 
section on  both  the  diseased  and  the  sound  side,  and  in 
cerebral  congestion  advises  also  a  stick  to  draw  into  the 
nose  of  the  patient,  that  the  double  hemorrhage  may  render 
the  cure  more  certain.  He  further  commends  the  pimper- 


BYZANTINE  AND  ARABIAN  SCHOOLS      153 

nel  in  hydrophobia,  and  pomegranate  bark  for  worms.  To 
detect  poison  in  a  wound  he  makes  use  of  a  poultice  of 
walnuts  laid  upon  it  and  afterward  thrown  to  a  fowl;  if 
the  fowl  eats  the  poultice,  the  wound  is  free  from  poison; 
ff  not,  it  is  not. 

Aetius  defended  the  Hippocratic  maxim  that  Nature 
should  be  permitted  to  have  her  own  way,  a  precept  to 
which  very  different  explanations  have  been  given  from 
Hippocrates'  time  down  to  the  present  day,  since  it  is  usu- 
ally "the  masters'  own  nature"  which  they  ask  others  to 
follow.  In  hectic  fevers  he  advises  nutritious  food;  in 
febrile  diseases  generally,  coolness  of  the  apartment. 
Typhoid  fever  manifests  as  its  chief  symptoms  stupor  and 
delirium,  febris  algida,  however,  an  icy  coldness. 

His  doctrine  of  fever,  according  to  which  the  seat  of 
fever  is  in  the  heart,  is  most  complete.  Fever  results 
chiefly  from  diseases  of  the  stomach  and  intestinal  canal. 
The  general  vitality  suffers  in  diseases  of  special  organs 
only  so  far  as  it  functionates  through  these  organs.  On 
mania  and  diseases  of  the  mind  in  general  he  makes  some 
admirable  observations.  His  methods  of  diagnosis  are 
comparatively  perfect.  Thus  he  employs  the  pressure  of 
the  fingers  for  the  detection  of  anasarca  (the  frequent 
inflammatory  nature  of  which,  indeed,  he  first  recognised)  ; 
palpation  in  enlargements  of  the  spleen;  inspection  in  the 
investigation  of  urinary  sediments,  which  he  discusses 
fully;  percussion  in  tympanites  and  succussion  in  ascites. 

The  diseases  occasioned  by  worms  he  describes  very 
well,  and  he  also  recognises  lung-stones,  so  that  he  had 
evidently  made  dissections.  His  views  on  the  place  where 
venesection  should  be  practiced  give  evidence  of  a  freedom 
from  prejudice  far  in  advance  of  his  time.  He  bled  from 
all  parts  of  the  body,  and  held  the  opinion  that  it  was  per- 
fectly immaterial  whether  the  operation  was  performed  in 
the  vicinity  of  the  diseased  parts  (as  Hippocrates  pre- 
ferred), or  (as  the  Methodists  directed)  on  the  opposite 
side,  since  all  the  veins  in  the  body  communicate.  He 


154  MEDICINE 

admonishes  his  colleagues  not  to  be  dazzled  by  the  glare 
of  "The  Authorities." 

In  striking  contrast  with  these  and  similar  sound  prin- 
ciples, however,  are  his  peculiarities  and  his  superstition, 
in  which  qualities  he  was  a  true  son  of  his  time.  Thus  in 
gout  he  recommends  a  very  complicated  antidote,  the  use 
of  which  is  to  be  begun  in  January,  and  continued  for  a 
year  and  a  day.  It  is  to  be  taken  100  days,  then  suspended 
for  30  days,  then  resumed  for  100  days,  then  suspended  15 
days,  then  it  is  prescribed  again  every  second  day  for  260 
days,  after  which  80  similar  doses  follow.  He  cures  the 
pains  of  colic  by  a  stone,  upon  which  is  engraven  the  figure 
of  Hercules  strangling  the  serpent,  or  by  an  iron  ring, 
upon  one  side  of  which  is  exhibited  an  incantation,  on 
the  other,  the  diagram  of  the  Gnostics. 

Theophilus  (circa  540  A.D.)  was  one  of  the  most  popular 
physicians  and  medical  authors  during  the  Middle  Ages, 
and  his  work,  'On  the  Structure  of  the  Body/  was  often 
made  the  basis  of  instruction  in  the  universities.  In  it, 
among  other  things,  the  olfactory  nerves  are  first  men- 
tioned as  a  special  pair  of  cerebral  nerves;  attention  is 
directed  to  the  dependence  of  the  development  of  the  skull 
and  vertebral  column  upon  that  of  the  brain  and  spinal 
cord,  and  reference  is  made  to  how  the  wisdom  and  good- 
ness of  the  Divine  Being  have  ordained  everything  so 
infinitely  perfect  as  to  give  to  the  hand  precisely  five  fin- 
gers, and  to  the  skull  a  spherical  form.  In  general  he 
follows  Galen. 

Paul  of  Aegina  (circa  560  A.D.)  was  the  last  of  the 
Greek  physicians  who  were  of  any  rank  in  medicine.  The 
military  surgery  of  Paul  is  very  complete,  clear,  and  suited 
to  the  weapons  of  the  period.  It  is  evidently  based  upon 
a  rich  experience,  for  he  had  seen  even  the  worst  injuries 
do  well,  and  in  operations  he  desires,  above  all,  that  the 
wounded  part  should  occupy  the  same  position  which  it 
had  occupied  at  the  moment  of  injury.  In  order  to  remove 
sling-stones,  darts,  arrow-heads,  etc.,  he  cuts  or  draws  them 


BYZANTINE  AND  ARABIAN  SCHOOLS     155 

out  or  pushes  them  through,  and  he  gives  judicious  pre- 
cautions to  avoid  the  injury  of  any  important  parts. 

Pathology  he  treats  from  head  to  foot,  after  the  method 
customary  in  his  day.  He  also  describes  specially  diseases 
of  the  skin  and  heart  (without,  however,  differentiating 
the  individual  diseases),  epidemic  colic,  and  ascribes  gout, 
very  properly,  to  an  inactive  life,  with  too  rich  food. 

From  the  foregoing  it  may  be  inferred  that  Paul  must 
have  been  one  of  the  most  capable,  if  not  the  most  daring 
operator  of  his  age.  His  experience  in  this  department 
of  the  healing  art,  and  particularly  at  this  time,  seems  the 
more  surprising,  since  for  centuries  before  him,  surgeons 
had  made  shift  with  an  apparently  inoffensive  surgery  of 
plasters  and  salves,  rather  than  resort  to  operative 
measures. 

After  the  destruction  of  the  Alexandrian  library  and  its 
medical  contents,  the  Arabians  turned  to  Grecian  sci- 
ence for  instruction  in  the  medical  arts.  They  followed 
Hippocrates  and  Galen,  translating  them  both  into  Arabic. 
The  works  of  Hippocrates  did  not  obtain  much  hold,  how- 
ever, on  account  of  the  simplicity  of  this  author,  whereas 
the  metaphysical  refinements  and  elaborate  arrangements 
of  Galen  pleased  the  Arabic  taste.  After  the  conquests, 
the  successors  of  Mahomet  rested,  and  seemed  disposed 
to  add  to  their  grand  empire  by  the  cultivation  of  the  arts 
of  peace.  They  even  translated  the  Greek  philosophers 
and  studied  them.  But  in  spite  of  all  this,  they  were  not 
open  to  this  form  of  intellectual  advancement,  and  no  ad- 
ditions were  made  to  general  science,  other  than  the  inven- 
tion of  chemistry  or  alchemy.  They  even  introduced  it 
into  medicine. 

Among  the  special  medical  branches,  practical  anatomy 
was  utterly  excluded  by  religious  belief,  and  midwifery 
and  gynecology  were  then  (as  almost  in  the  East  to-day) 
forbidden  to  men.  The  practice  of  operative  surgery,  too, 
was  considered  unworthy  of  a  man  of  honor,  and  was 
permitted  only  to  the  despised  lithotomists  and  similar  per- 


156  MEDICINE 

sons  of  the  lower  class,  who  in  consequence  of  the  fatalism 
of  the  Arabians  (in  spite  of  the  remarkable  tolerance  of 
the  Orientals,  even  to-day,  for  painful  operations),  were 
very  rarely  allowed  to  have  recourse  to  the  knife. 

"Operations  performed  by  the  hand,  such  as  venesec- 
tion, cauterization,  and  incision  of  arteries,"  says  a  writer 
of  this  period,  "are  not  becoming  a  physician  of  respecta- 
bility and  consideration.  They  are  suitable  for  the  physi- 
cian's assistants  only.  These  servants  of  the  physician 
should  also  do  other  operations,  such  as  incision  of  the 
eyelids,  removing  the  veins  in  the  white  of  the  eye  and 
the  removal  of  cataract.  For  an  honorable  physician  noth- 
ing further  is  becoming  than  to  impart  to  the  patient  ad- 
vice with  reference  to  food  and  medicine.  Far  be  it  from 
him  to  practice  any  operation  with  the  hands."  Even  the 
extraction  of  teeth  was  avoided,  and,  although  dentistry 
was  cultivated,  as  among  the  ancients,  it  was  practiced 
only  by  the  lower  class  of  physicians,  the  assistants. 

Medicine  proper  was  chiefly  taught  Chemistry,  phar- 
macy and  materia  medica,  and  indeed,  the  history  of  medi- 
cine were  also  well  cultivated.  They  were  the  first  to 
describe  smallpox.  They  greatly  improved  drugs,  due 
mainly  to  their  researches  in  chemistry. 

Rhazes  (932-1010  [  ?] )  was  a  prolific  writer,  but  blindl/ 
followed  Galen.  His  most  important  additions  to  knowl- 
edge were  in  surgery  and  in  pharmacy.  His  semeiology 
and  prognostics,  with  the  exception  of  the  indications  to  be 
derived  from  the  urine  and  the  planets,  are  famous ;  yet 
his  anatomical  and  physiological  knowledge  never  exceeds 
that  of  Galen. 

Avicenna  in  the  tenth  century  wrote  a  work  which 
contains  substantially  the  conclusions  of  the  Greeks,  and 
was  the  text-book  and  law  of  the  healing  art,  until  modern 
times.  It  includes  anatomy,  physiology  and  materia  medica. 
In  it  are  mentioned  camphor,  iron  in  various  forms,  amber, 
aloes,  manna  and  many  other  drugs.  He  considers  gold 


BYZANTINE  AND  ARABIAN  SCHOOLS     157 

and  silver  as  "blood-purifiers";  hence  gilded  and  silvered 
pills  are,  in  his  view,  specially  efficacious. 

His  pathology  makes  prominent  mention  of  mental  dis- 
eases, and  notices  tic  douloureux  (described  also  by  other 
Arabians),  tetanus,  three  forms  of  inflammation  of  the 
chest — pleuritis,  muscular  rheumatism  and  mediastinitis — 
measles  and  the  purples.  He  is  also  said  (according  to 
Leichtenstern)  to  have  been  the  first  physician  to  teach  the 
contagiousness  of  phthisis.  In  his  general  pathology  and 
therapeutics  he  distinguishes,  among  other  matters,  fifteen 
kinds  of  pain,  and  preserves  the  Galenic  humoral  pathol- 
ogy. In  great  coldness  and  in  great  heat  he  gives  no  med- 
icines, and  considers  the  same  remedy  good  in  one  locality, 
which  would  be  injurious  if  employed  in  another. 

In  surgery  he  calls  the  extraction  of  a  cataract  a  dan- 
gerous operation,  but  speaks  in  favor  of  depression;  de- 
clines to  operate  on  strangulated  hernia;  describes  punc- 
ture of  the  bladder;  the  method  by  which  leeches  and 
other  foreign  bodies  when  swallowed  may  be  removed  from 
the  oesophagus,  hardened  wax  removed  from  the  meatus, 
etc.,  while  he  prefers  to  loosen  the  teeth  by  means  of  the 
fat  of  tree-toads,  rather  than  to  pull  them  out.  In  ob- 
stetrics he  follows  the  views  of  the  earlier  writers.  In 
military  surgery  (according  to  Frohlich)  he  taught  only 
very  little,  and  this  he  borrowed  from  the  Greeks,  without 
giving  his  own  experience. 

Albucasis,  later  in  the  same  century,  is  the  last  of  the 
Arabian  physicians  to  attain  any  distinction  as  a  writer. 
His  principal  work  is  on  surgery,  and  he  was  as  famous 
as  a  surgeon  as  was  Avicenna  in  medicine.  He  performs 
venesection,  after  the  manner  of  the  Arabians,  upon  the 
sound  side  and  recommends  the  employment  of  the  same 
with  the  view  of  prophylaxis,  an  idea  from  which  subse- 
quently originated  a  pernicious  custom.  Besides  the  sur- 
gical diseases  already  noticed  from  his  treatise  on  opera- 
tions, he  recognises  a  gangrenous  epidemic  erysipelas, 
warty  excrescences,  fractures,  which,  after  the  manner 


158  MEDICINE 

of  his  age,  he  rectifies  by  means  of  machines — a  cruel  pro- 
cedure of  which  reminiscences  still  exist  among  the 
public.  Plates  of  instruments  adorn  the  work.  He 
valued  anatomy  as  an  important  aid  in  the  practice  of 
surgery.  This  was  unusual  and  interesting  in  an  Arabian. 
He  was  a  bold  operator  and  a  man  of  keen  insight.  His 
work  on  surgery  was  the  most  complete  of  that  time,  and 
was  used  for  years  after  his  death  as  a  text-book. 

The  celebrity  of  the  Arabian  school  of  medicine  is  based, 
not  on  its  real  merits,  but  on  the  fact  that  the  surrounding 
countries  were  in  a  very  much  lower  state  of  medical 
knowledge.  From  the  eighth  to  the  twelfth  centuries  was 
the  period  of  Europe's  most  complete  superstition  in  nat- 
ural science.  The  principal  remains  of  a  taste  for  litera- 
ture and  science,  or  for  the  fine  arts,  were  found  among  the 
Moors  and  Arabs;  and  it  was  from  this  source,  by  the 
intervention  of  the  crusaders,  and  the  intercourse  which 
was  thus  effected  between  the  Asiatics  and  Europeans,  that 
the  philosophical  and  medical  writings  of  the  Greeks  were 
first  made  known  to  the  inhabitants  of  Italy  and  France. 
For  some  time  after  their  introduction  into  Europe,  they 
were  still  translated  from  the  Arabic,  and  it  was  not  until 
much  later  that  they  were  read  in  Greek.  Inasmuch  as  the 
study  of  the  Greek  tongue  was  so  completely  suspended 
'during  the  Dark  Ages,  it  is  possible  that  the  writings  of 
the  ancient  physicians  might  have  been  lost  to  posterity, 
if  they  had  not  been  preserved  in  these  Arabic  translations. 

There  are  two  points  in  which  the  Arabians  conferred  a 
real  obligation  upon  their  successors — the  introduction  of 
various  new  articles  into  the  materia  medica,  and  the 
original  description  of  certain  diseases.  The  Arabian  school 
is  said  to  be  the  first  to  found  a  hospital  in  which  medical 
students  received  clinical  instruction.  The  menace  of 
Saracenic  power  was  real  and  terrifying  to  Southern 
Europe,  its  unchecked  success  might  have  been  fraught 
with  disastrous  results  to  civilization,  but  at  least  the  very 
nearness  of  the  peril  led  to  the  acquisition  from  the  Orient 


BYZANTINE  AND  ARABIAN  SCHOOLS     159 

by  the  Occident  of  the  elements  of  an  almost  forgotten 
learning. 

After  the  extinction  of  the  Saracenic  school  in  Spain, 
there  is  an  interval  of  about  three  hundred  years,  from  the 
twelfth  to  the  fifteenth  centuries,  during  which  time 
Europe  was  enveloped  in  scientific  darkness.  Every  de- 
partment of  natural  investigation  was  neglected,  and  med- 
icine, as  a  science,  fell  into  its  lowest  state  of  degradation. 
What  remained  was  in  the  possession  of  the  monks,  who 
regarded  knowledge  as  being  useless  unless  it  had  some 
theological  bent,  and  who  desired  to  keep  mankind  looking 
ever  to  a  future  world  and  not  to  this.  The  practice  of 
medicine,  if  such  it  may  be  called,  was  chiefly  in  their 
hands,  and  they  adhered  closely  to  the  principles  and  prac- 
tices of  Galen.  But  mixed  with  these  was  a  large  portion 
of  superstition,  magic  and  astrology.  By  means  thus  em- 
ployed, they  gradually  came  to  possess  a  profound  influence 
over  the  minds  of  the  people,  and  operated  so  powerfully 
on  the  imagination  of  their  patients  that  their  doings 
seemed  almost  supernatural. 

It  is  certain,  however,  that  there  were,  besides  the 
monkish  physicians,  laymen  who  practiced  medicine,  but 
they  held  no  such  position  as  once  they  had.  The  lay  phy- 
sician was  not  looked  upon  as  a  learned  man,  for  the 
latter  was  one  who  had  been  duly  instructed  in  a  monastic 
school,  where  the  curriculum  would  not  admit  the  art  of 
medicine,  wherefore  the  lay  physician  was  considered  as  a 
mechanic  or  tradesman.  Laws  were  enacted  to  restrain 
and  govern  these  men,  and  they  were  made  responsible  for 
any  want  of  skill,  while  the  fee  for  any  given  piece  of 
surgery  or  medical  advice  was  stipulated. 

In  addition  to  the  monks,  there  existed  also  many  Jewish 
physicians,  who  had  been  educated  at  Alexandria,  later  in 
the  Arabian  school,  and  they  were  lay  physicians  of  a 
high  order.  They  attended  princes  and  even  popes,  in 
spite  of  edicts  of  the  Church  prohibiting  this  very  thing. 
The  monks,  however,  held  the  highest  place,  which  was 


Fig.  5 — AN  ASTROLOGICAL  DIAGNOSIS 

"  The  signe  ascending,  viz.,  TI&,  is  in  the  figure  most  afflicted 
by  the  corporall  presence  of  $  ,  who  is  partly  lord  of  the  eighth 
house ;  therefore  from  that  house  and  signe  must  we  require  the 
disease,  cause,  and  member  grieved.  %?  being  the  signe  of  the 
sixt,  is  fixed,  afflicted  by  £5 ;  and  ^  ,  who  is  lord  of  the  sixt  house, 
is  in  tf ,  a  fixed  signe,  earthly  and  melancholy,  of  the  same 
nature  and  triplicity  that  TT&,  the  signe  ascending,  is  of;  the  D 
being  a  general  significatrix  in  all  diseases,  being  afflicted  by 
her  proximity  to  $  ,  and  posited  in  the  ascendant  in  an  earthly 
melancholy  signe,  together  with  the  other  significators,  did  por- 
tend the  patient  to  be  wonderfully  afflicted  with  the  spleen,  with 
the  wind-cholick,  and  melancholy  obstructions,  small  feavers,  a 
remisse  pulse;  and  as  the  signe  TT£  is  the  signe  ascending,  and 
5)  and  $  therein,  it  argued,  the  sick  was  perplexed  with  dis- 
tempers in  his  head,  slept  unquietly,  etc.  [A II which  was  true^\ 
I  perswaded  the  man  to  make  his  peace  with  God,  and  to  settle 
his  house  in  order,  for  I  did  not  perceive  by  naturall  causes  that 
he  could  live  above  ten  or  twelve  days" — (Lilly). 


BYZANTINE  AND  ARABIAN  SCHOOLS     161 

low  enough  to  be  sure,  until  the  solid  foundation  of 
Salerno  and  the  European  universities.  Yet  there  were 
many  of  the  clergy,  especially  among  the  Benedictines, 
who  studied  the  ancient  physicians  and  were  more  worthy 
of  the  name.  Under  the  direction  of  the  Church,  many 
institutions  and  orders  sprang  up.  These  had  in  view  the 
helping  of  diseased  and  maimed  mankind,  and  houses  were 
used  especially  for  their  care  and  maintenance.  The 
monks  were  restrained  from  malpractice  by  the  orders  of 
the  Church.  Their  medical  practices  were  theurgic  to  an 
extreme  degree.  Prayers,  amulets  and  many  superstitions 
were  employed  generally  and  openly  for  the  cure  of  every- 
day diseases.  Sickness  was  regarded  as  punishment  from 
God,  or  a  visitation  from  the  devil  (ideas  by  no  means 
foreign  to  the  present  day).  The  monks  held  the  principle 
of  'similia  similibus/  and  "treated  the  poisoning  oc- 
casioned by  swallowing  a  toad  by  directing  the  patient  to 
eat  another  toad."  The  higher  monks  were  first  restrained 
in  the  twelfth  century,  and  the  practice  of  medicine  for- 
bidden them.  Then,  later,  the  lower  monks  were  also 
restricted,  and  particularly  all  burning  and  cutting 
(surgery)  were  forbidden  them  on  the  principle:  "The 
Church  shuns  bloodshed." 

The  Benedictines  were  the  most  scientific  of  the  monks, 
and  they  cultivated  medicine  to  a  considerable  extent.  An 
excellent  influence  upon  medieval  medicine  and  its  de- 
velopment was  exercised  by  the  monastic  infirmary  at 
Monte  Cassino,  and  still  more  eminently  and  effectively  by 
the  school  of  Salerno.  The  former,  founded  by  St.  Bene- 
dict himself,  was  mainly  for  practice  rather  than  in- 
struction, and  miracles  were  said  to  be  performed  here. 
The  monks  came  from  foreign  lands  to  learn  treatment  and 
to  study.  The  glory  of  Monte  Cassino  was  displaced  by 
Salerno,  which  attained  its  greatest  position  in  the  twelfth 
century.  It  held  its  prominence  for  more  than  a  century, 

Salerno  was  founded  as  early  as  200  B.C.  by  the  Romans, 
and  because  of  its  charming  situation  and  climate,  it  en- 


162  MEDICINE 

joyed  a  wide  reputation  as  a  health  resort.  It  is  probable, 
therefore,  that  physicians  were  always  located  there. 
After  the  establishment  of  Christianity,  it  became  the 
resort  for  pilgrims,  as  well  as  a  kind  of  medical  resort. 
The  dissection  of  a  body  was  allowed  every  five  years. 
This  was  allowed  by  Salerno's  patron,  Frederick  II.  The 
importance  of  Salerno  as  regards  medical  culture  depends 
not  on  any  wonderful  contributions  to  science,  but  rather 
because  the  principles  of  the  great  ancients  were  preserved 
in  the  Greek  itself,  and  also  through  Arabians. 

The  school  of  Montpellier  was  equally  important  in  the 
culture  of  the  West,  for  here,  too,  they  studied  the 
ancients,  especially  Hippocrates,  and  also  the  Arabians 
and  Galen.  The  reputation  of  the  school  was  so  great  that 
to  have  studied  there  lent  a  halo  of  glory  to  the  monkish 
physician.  They  were  liberal  in  viewpoint  and  demon- 
strated their  practical  scientific  tendency  by  allowing  the 
annual  dissection  of  a  criminal  corpse  (1376).  About  this 
time,  other  universities  sprang  up  at  Bologna,  Oxford  and 
Paris.  These  helped  to  start  that  reformation  of  thought 
which  came  later.  The  number  of  students  speedily  be- 
came very  great,  and  often  formed  whole  communities. 
The  course  of  instruction  in  medicine  was  carefully 
watched  over  by  the  Church  and  subsequently  by  the 
State. 

The  great  Hohenstaufer  Frederick  II.,  enlightened  by 
the  wisdom  of  the  Orient,  was  especially  active  in  the  pro- 
motion of  education,  and  above  all,  in  the  elevation  of  the 
position  of  physicians.  He  paid  no  heed  to  the  triple  ban 
of  Pope  Gregory  IX.  (1227-1241),  and  by  his  promotion  of 
medical  studies  and  educational  institutions  he  became  a 
benefactor  of  mankind,  and  especially  of  Italy.  Through 
his  medical  ordinance,  published  in  1224,  he  has  secured 
for  himself  forever  an  honorable  place  in  the  history  of 
medical  culture.  Some  of  his  reforms  were  of  the  nature 
of  restraint  and  government  of  the  practice  of  medicine. 
The  surgeon  must  bring  evidence  that  he  had  attended  the 


BYZANTINE  AND  ARABIAN  SCHOOLS     163 

lectures  of  the  professors,  and  pursued  for  one  year  the 
curriculum  which  surgeons  held  necessary,  especially 
human  anatomy.  Surgeons  of  the  first  class  were  exam- 
ined by  three  professors,  of  whom  one  teacher  of  surgery 
conducted  the  examination  in  the  Latin  language,  and  in 
the  presence  of  the  prosector  of  the  nation  of  the  candidate. 

The  foundation  of  the  new  universities  did  two  things 
to  further  medicine;  one  was  that  medicine,  its  teaching 
and  to  a  certain  extent  its  practice,  fell  into  the  hands  of 
men  who  were  thinkers  and  learned,  and  the  other  was 
the  introduction  of  the  so-called  scholastic  philosophy. 
The  teachings  of  the  Greek  physicians,  and  the  elaborations 
of  those  teachings  by  the  Arabs,  were  cherished  as  very 
gospel,  and  the  physicians  of  the  period  made  no  effort  to 
change  or  add  to  them.  Aristotle's  philosophy,  combined 
with  Arabian,  extended  up  to  the  seventeenth  century. 

This  period,  better  known  as  the  Age  of  the  Arabists, 
is  characterized  by  the  medical  men,  both  clergy  and  lay- 
men, following  the  Arabians  in  science  and  practice.  There 
was  one  famous  Peter  Abano,  who  lived  near  Padua,  who 
was  a  man  of  refined  views,  altho  markedly  superstitious. 
He  wrote  several  books  on  science. 

A  circumstance  which  tended  to  shake  the  authority  of 
Galen,  and  to  diminish  the  veneration  in  which  his  opin- 
ions had  been  held  for  so  many  ages,  was  the  rise  of  the 
sect  of  Chemical  Physicians.  After  chemistry  had  been 
used  with  advantage  for  the  purpose  of  improving  phar- 
macy, it  was  applied  to  the  explanation  of  the  phenomena 
of  vitality  and  of  the  operation  of  morbid  processes  upon 
the  living  organism.  The  theories  of  these  chemists  were 
false,  but  they  served  to  divide  the  profession,  and  acted 
as  a  wedge  in  the  downfall  of  Galen's  long  influence. 

The  revival  of  human  anatomy  in  the  fourteenth  century 
was  so  great  an  epoch  in  the  history  of  medicine  that  it 
marks  the  point  of  turning  toward  modern  science.  Com- 
merce, business,  manufactures  and  the  higher  arts  were 
more  and  more  cultivated,  especially  in  Italy.  In  1330, 


164  MEDICINE 

the  invention  of  gunpowder  by  Berthold  Schwartz,  so 
important  in  the  history  of  civilization,  was  later  the  means 
of  reforming  surgery.  Anatomy,  in  its  practical  human 
aspect,  became  an  openly  recognised  department  of  medical 
science. 

After  the  period  of  the  Alexandrian  anatomists,  human 
anatomy,  especially  the  practical  portion  of  it,  again  had 
almost  disappeared  from  the  list  of  medical  studies,  tho 
here  and  there  probably  a  sort  of  dissection  may  still  have 
been  practiced.  Even  Galen  dissected  only  animals,  and  he 
considered  it  one  of  the  great  advantages  of  Alexandria 
that  human  skeletons  could  there  be  seen.  In  the  early 
Middle  Ages  the  monks  would  have  tolerated  such  a 
process  quite  as  little  as  the  Koran,  feeling  it  to  be  an 
impairment  of  the  capacity  for  resurrection,  a  belief  still 
supposed  to  be  involved  in  anatomical  dissection. 

How  early,  and  where  human  dissections  in  aid  of  an- 
atomical studies  were  revived,  is  unknown.  This  much, 
however,  is  certain,  that  the  Senate  of  Venice  (in  spite  of 
the  prohibition  by  Pope  Boniface  VIII.,  eight  years  be- 
fore) decreed  in  the  year  1308,  that  a  human  body  should 
be  dissected  annually.  From  this  express  decree  it  would 
seem  to  follow  that  this  had  already  been  often  done  here- 
tofore. At  all  events,  William  of  Salicet  and  others  in 
Bologna  had  performed  dissections.  But,  as  a  matter  of 
historical  fact,  the  credit  of  the  revival  of  dissection  be- 
longs to  Mondino  alone,  who  took  hold  of  the  subject  at 
the  psychological  moment. 

Mondino  de  Luzzi  was  one  of  the  first  of  this  period, 
the  fourteenth  century,  to  write  a  treatise  on  anatomy  and 
dissection  of  the  human  body.  His  work  is  written  entirely 
in  the  spirit  of  the  Arabians,  and  he  followed  Galen  in 
describing  the  abdominal  walls  as  being  constructed  with- 
out bony  supports,  in  order  to  stretch  sufficiently  in  cases 
of  flatulence  and  abdominal  dropsy,  if  perchance  these  dis- 
eases should  befall  one. 

Mondino,  to  escape  burdening  his  soul  with  mortal  sin, 


BYZANTINE  AND  ARABIAN  SCHOOLS     165 

did  not  yet  venture  to  open  the  skull,  but  others  were  less 
fearful,  and  investigations  were  soon  so  popular  that  bodies 
for  dissection  were  stolen,  if  they  could  not  be  otherwise 
obtained.  The  description  was  read  from  the  book,  as  the 
professor  did  not  dream  of  soiling  his  ringers  by  actually 
handling  the  body.  Mondino's  work  was  designed  to  be 
such  a  text-book  of  anatomy,  and  it  maintained  general 
acceptance  as  such  down  to  the  close  of  the  Middle  Ages. 

After  Mondino,  little  further  advance  was  made  for  two 
centuries  in  anatomy,  but  a  general  spirit  of  progress  now 
manifested  itself  in  the  arts  and  other  sciences ;  philosophy 
in  all  its  branches  was  studied  on  a  more  correct  plan,  and 
medicine  accordingly  improved.  One  of  the  first  symptoms 
of  this  improvement  was  the  increasing  relish  for  the 
writings  of  Hippocrates,  and  a  revival  of  his  method  of 
studying  and  practicing  medicine. 

Probably  as  a  result,  first,  of  the  influence  of  the  Cru- 
sades, in  which  many  wounds  were  inflicted  and  subse- 
quently treated;  second,  of  the  revival  of  anatomy,  many 
surgeons  of  this  period  were  excellent  anatomists.  As  a 
result  of  the  invention  of  gunpowder  and  its  application  to 
instruments  of  war,  the  surgical  wounds  changed  in  char- 
acter, requiring,  in  their  treatment,  a  more  thorough 
knowledge  of  anatomy.  On  account  of  these  things, 
surgery  advanced  with  great  strides,  and  that  in  spite  of 
the  fact  that  it  still  remained  in  the  hands  of  the  lower  sur- 
geons who  were  originally  assistants  of  the  clergy. 

In  Italy,  surgery  remained  united  with  the  practice  of 
medicine,  and  was  practiced  by  all  physicians  who  pro- 
fessed to  be  general  doctors.  It  was  always  held  in  high 
esteem,  both  by  the  profession  and  by  laymen  in  general, 
and  never  fell  into  the  disreputable  position  that  once 
existed  in  France.  The  surgeons  of  Italy  were  particu- 
larly clever  in  developing  plastic  surgery  by  the  construc- 
tion of  artificial  noses  and  ears.  In  France,  on  the  other 
hand,  surgery  became  entirely  separated  from  medicine  in 
the  second  half  of  the  Middle  Ages. 


166  MEDICINE 

A  class  arose  called  "Barber  Surgeons,"  because  they 
shaved,  and  performed  menial  jobs  of  all  sorts.  They  de- 
veloped surgery  very  largely,  forming  themselves  into  a 
distinct  profession,  possessing  a  college  of  their  own.  Later 
they  divided  into  guilds  of  "superior"  and  "inferior"  sur- 
geons, the  former  being  subordinate  to  the  latter,  while 
both  were  under  control  of  the  physicians  of  internal  med- 
icine, called  the  Faculty.  These  surgeons,  who  were  called 
"surgeons  of  the  long  robe,"  later  formed  a  college,  and 
separated  themselves  from  the  barbers,  called  "surgeons  of 
the  short  robe." 

Guy  de  Chauliac  (1300)  was  one  of  the  distinguished 
surgeons  of  early  France.  He  showed  wonderful  compre- 
hensiveness and  judgment  in  his  work,  and  in  its  descrip- 
tion. His  own  observations  of  diseases,  and  his  knowl- 
edge of  anatomy  were  considerable.  He  used  the  thermo- 
cautery  in  treatment  of  cancer,  which  he  declared  was 
allied  to  leprosy.  Non-ulcerating  cancer  he  operated  on 
and  cut  out  from  the  roots.  Operations  on  diseases  of  eye, 
and  treatment  of  fractures,  were  well  performed,  He 
trephined  the  skull,  performed  lithotomy,  and  operated  on 
nose  and  throat.  Hemorrhage  he  divides  correctly  into 
arterial,  or  spurting,  and  venous,  and  his  hemostasis  con- 
sisted in  modern  methods  of  styptics,  suturing,  division  of 
half-severed  vessels,  actual  cautery  and  ligation. 

During  the  fourteenth  and  fifteenth  centuries  formidable 
diseases  made  their  appearance  in  Europe.  Some  of  the 
causes  were  in  part  prolonged  in  their  effect  from  the  last 
days  of  antiquity,  but  the  origin  of  others  is  still  obscure. 
Among  these  one  of  the  most  remarkable  was  the  Sudor 
Anglicanus,  which  is  first  mentioned  about  the  end  of  the 
fifteenth  century,  and  which  for  about  fifty  years  raged  at 
intervals  with  extreme  violence  in  England  and  Western 
Europe.  This  disease,  "English  sweating  sickness,"  as  its 
name  implies,  was  characterized  by  a  severe  sweating 
which  consumed  the  strength  of  the  patient,  followed  by 
terrible  headaches,  irregular  heart  action,  delirium,  stupor 


BYZANTINE  AND  ARABIAN  SCHOOLS      167 

and  finally  death,  all  in  the  short  space  of  twenty-four 
hours. 

Another  terrible  and  very  widespread  disease  was 
leprosy.  Hospitals  and  pest-camps  were  founded  for  these 
afflicted  persons,  who,  if  in  fairly  good  health,  had  to  go 
about  dressed  in  a  marked  manner — a  black  gown  with  two 
white  bands  sewed  upon  the  breast,  and  a  large  hat  with  a 
white  band  upon  the  head.  Whatever  they  wished  to  buy, 
they  must  point  out  with  a  long  stick,  and  their  approach 
must  be  indicated  with  a  rattle. 

"Holy-fire,"  or  ergotism  as  it  is  now  understood,  was, 
if  anything,  worse  than  leprosy,  for  it  maimed  horribly 
those  who  did  not  die,  deprived  them  of  a  hand  or  foot. 
It  is  a  gangrenous  disease  caused  by  eating  a  fungus  of 
rye,  in  bread,  and  is  very  painful.  Scurvy  was  another 
disease  due  to  malnutrition  and  improper  feeding.  It  was 
most  marked  and  diffuse  in  the  fifteenth  century,  when  it 
sprang  out  among  those  who  traveled  at  sea  for  any  length 
of  time,  where  they  could  get  no  fresh  vegetables  or  fruits, 
but  must  needs  eat  salt  pork  and  dry  biscuits. 

Epidemics  of  influenza  appeared  in  the  early  ages,  and 
from  those  times  it  has  been  the  custom  to  say,  after  sneez- 
ing, "God  help  us/'  because  those  attacked  with  this  dis- 
ease, often  died  too  quickly  to  expect  aid  from  human 
hands.  "The  Black  Death"  was  a  most  terrible  and  de- 
structive plague.  It  is  computed  that  fully  one-fourth  of 
all  mankind  was  swept  away  by  this  plague !  Besides 
these  awful  diseases,  there  were  many  famines,  brought 
on  about  every  decade  or  so,  because  of  the  widespread 
lack  of  cultivation  of  the  lands,  and  the  universal  insecurity 
of  property. 


CHAPTER  V 

THE   CLOSE   OF   MEDIEVALISM 

AT  the  beginning  of  the  Modern  Era,  continuing  of 
course  from  the  Middle  Ages,  the  influences  of  superstition 
and  ignorance  were  not  at  once  obliterated,  nor  are  they 
even  to  the  present  day.  Martin  Luther  himself,  the  cen- 
tral figure  of  the  greatest  political  and  religious  movement 
of  all  modern  centuries,  believed  absolutely  in  the  devil 
incarnate,  and  in  all  diseases  he  regarded  the  influence  of 
Satan  as  paramount.  The  physicians  were  likewise  under 
this  influence.  Even  Pare  believed  in  the  workings  of 
demons  and  the  devil.  And  if  great  minds  like  those  of 
Luther  and  Pare  are  found  to  have  been  fettered  to  those 
old  ideas  and  beliefs,  how  much  more  must  the  lower 
classes  and  the  ignorant  have  been  ? 

But  the  most  powerful  agents  in  bringing  about  a  better 
era  were  the  new  philosophical  and  skeptical  currents  of 
thought  which  arose  to  subject  all  medievalism  to  the  tests 
of  proof  and  doubt.  This  spread  of  new  thought  was  due 
mainly  to  universal  schooling  and  mental  culture.  Another 
influence  which  soon  brought  about  an  improvement  in 
thought  and  education  was  commerce,  developing  ocean 
travel  and  through  it  bringing  men  of  different  languages 
and  customs  into  intimate  contact  with  each  other. 

Medicine  in  the  beginning  of  the  Modern  Era  received 
its  mightiest  impulse  from  the  same  strongly  Protestant 
and  progressive  spirit  which  in  the  department  of  religion 
broke  the  solidarity  of  the  ancient  Church.  In  medicine, 

168 


THE  CLOSE  OF  MEDIEVALISM 


169 


however,  this  spirit  was  led  not  only  against  the  Church 
but  also  against  Galen,  against  the  Arabians  and  against 
the  superstition  of  the  priests  and  monks.  Thus  was  called 


Fig.  6 — PHARMACY  DURING  REVIVAL  OF  LEARNING 

into  existence  a  national  medicine  which  through  the  liv- 
ing spirit  of  the  nations  and  through  their  language  won 
fresh  momentum.  The  new  forms  of  disease  which  had 
arisen  in  the  last  years  of  the  Middle  Ages  brought  a  more 


170  MEDICINE 

reliable  differentiation  of  the  species  of  disease.  The  eti- 
ology and  treatment  of  those  new  diseases  could  not  be 
found  in  the  records  of  the  ancients,  for  the  latter  had 
never  seen  them;  so  it  was  a  matter  of  sheer  necessity  to 
investigate  them  and  learn  all  that  was  possible.  The  allied 
sciences  of  chemistry  and  botany,  supplied  with  new  ma- 
terial from  the  Old  World,  also  advanced  in  many  positive 
ways  into  the  sphere  of  Medicine.  Anatomy,  already 
started  on  its  correct  basis,  and  physiology,  which  is 
founded  upon  anatomy,  both  advanced  more  rapidly. 

The  sixteenth  century  is  as  important  in  the  development 
of  medicine  and  its  allied  branches  as  was  the  age  of  Hip- 
pocrates, for  during  this  time  his  principles  and  precepts 
were  developed  to  a  most  wonderful  degree.  It  was  the 
century  of  reformation,  of  struggle  and  of  protest  against 
all  medicine  which  had  abandoned  the  teachings  of  Hip- 
pocrates ;  it  was  the  outcry  against  tradition  and  authority 
and  for  correct  principles  of  observation  of  nature.  The 
levers  whereby  this  reform  was  accomplished  were  human- 
ism, the  new  anatomy,  new  diseases  and  the  rebellion  of 
Paracelsus  and  Pare. 

Altho  there  is  found  an  earnest  effort  to  advance,  a 
retrograde  impulse  of  equal  strength  made  itself  manifest. 
Beside  the  clearest  discernment  stood  darkest  superstition ; 
beside  poor  dupes  stood  the  grandest  impostors.  At  this 
time  are  found  the  superstitious  physicians  preaching  that 
astrology  is  necessary  for  the  study  and  the  treatment  of 
disease,  while  the  belief  in  witches  and  their  trials  were 
approved  by  a  large  majority  of  the  medical  profession. 
The  advances  in  mathematics  and  astronomy  under  the 
influence  of  the  Copernican  system  laid  the  foundation  for 
the  final  disbelief  in  astrology.  The  physicians  of  the  six- 
teenth century  were  very  active  in  philology  and  in  trans- 
lating and  commenting  upon  the  works  of  the  ancients  and 
the  influence  of  these  works  was  immediate.  The  reform 
proceeded  from  no  single  individual  nor  even  from  any  one 
nation.  The  reaction  became  universal  against  Galen  and 


THE   CLOSE   OF   MEDIEVALISM  171 

the  Arabians  and  terminated  with  their  almost  complete 
demolition.  The  first  combustible  thrown  into  the  stag- 
nant air  of  blind  faith  in  authority  was  in  the  form  of  a 
dispute  concerning  the  proper  place  for  venesection  in 
pleurisy,  meaning  both  pleuritis  and  pneumonia.  Now  it 
seems  a  trivial  thing,  but  at  that  time  was  so  important 
that  the  medical  profession  was  divided  into  two  camps. 
The  site  to  be  chosen  for  bleeding  was  the  whole  subject 
of  contention. 

Pierre  Brissot,  a  Parisian  (1478-1522),  taught  the  Hip- 
pocratic  method  of  venesection.  Many  came  to  his  side, 
but  he  gained  more  adversaries.  Both  Vesalius  and  Pare 
followed  Brissot. 

Paracelsus  (Theophrastus  von  Hohenheim)  lived  about 
the  same  time  as  Brissot.  He  was  instructed  first  by  his 
father,  who  taught  him  alchemy,  astrology  and  medicine. 
He  studied  at  the  University  of  Basle  and  later  traveled  as 
an  itinerant  student  and  surgeon  in  the  wars.  He  was  the 
first  to  deliver  lectures  on  medicine  in  anything  but  the 
Latin  language;  that  is,  in  Germany.  As  a  result  he  had 
a  great  many  hearers.  But  Paracelsus  was  far  from  mod- 
est concerning  his  own  ability  and  standing.  He  pro- 
claimed himself  the  greatest  medical  genius  of  Germany 
and  compared  himself  with  Hippocrates,  whom  he  revered. 
As  an  outward  and  popular  sign,  he  burnt  the  works  of 
Galen  and  Avicenna  in  his  lecture  rooms,  thus  showing  his 
unbelief  in  and  disdain  for  these  ancient  authorities.  He  be- 
lieved that  experience  and  observation  made  the  physician, 
not  the  knowledge  of  Latin  and  Greek  and  the  useless  prin- 
ciples of  the  ancients.  Altho  not  properly  educated  in  his 
department,  he  was  possessed  of  ingenious  medical  in- 
stincts and  through  his  extensive  travels  was  better  fitted 
for  the  work  of  a  reformer  than  were  the  literati  of  the 
profession,  who  trod  universally  the  paths  of  Galen  and 
the  Arabians. 

His  humanity  and  charity,  virtues  of  the  genuine  physi- 
cian, were  famous.  If  he  was  rough  and  unpolished,  it 


172  MEDICINE 

was  because  the  times  developed  such  men,  and  he  could 
be  gentle  and  kind.  The  influence  that  Paracelsus  exerted 
was  mostly  on  the  Germans,  because  he  wrote  and  spoke 
only  in  that  language.  Furthermore,  his  influence  was  lim- 
ited to  the  unlearned  rather  than  the  learned,  for  the  very 
reason  that  he  did  not  know  Latin  and  Greek,  in  which 
languages  medicine  had  always  heretofore  been  taught. 
Paracelsus  was  both  a  surgeon  and  a  physician,  at  that 
time  a  rare  circumstance,  and  he  points  out  with  great 
clearness  and  comprehension  the  great  value  of  the  alliance 
of  these  two  departments  of  the  medical  science.  Altho  he 
was  himself  no  operator,  he  taught  the  principles  of  the 
treatment  for  wounds.  He  held  very  strongly  to  the  clean- 
liness of  wounds,  almost  too  strongly  in  direct  opposition 
to  the  customs  of  the  day,  recommended  spare  diet  and 
regulation  of  drink.  In  the  treatment  of  ulcers  he  was  less 
clear,  but  he  used  to  good  advantage  mineral  remedies  and 
compression  with  bandages. 

The  physiology  of  Paracelsus  recognises  as  the  proper 
active  and  life-giving  agent  in  man  his  'archeus/  whose 
home  is  in  the  stomach,  who  separates  the  material  useful 
for  nutrition  (the  'essence')  from  the  useless  (the  'poi- 
son') and  becomes  thus  the  'alchemist  of  the  body/  More- 
over, he  is  the  spirit  of  life,  the  'astral  body/  The  poison 
is  excreted  by  two  routes — all  excrements  are  therefore 
poisons — and  the  essence  remains  in  the  body.  It  nour- 
ishes and  maintains  the  latter,  while  each  part  and  each 
member  (since  all  possess  their  own  special  archeus,  al- 
chemist or  stomach)  attracts,  extracts  and  assimilates  what 
is  appropriate  for  it.  Digestion  is  a  kind  of  putrefaction 
by  which,  on  the  one  hand  the  assimilation  of  the  nutritive 
slime,  on  the  other  the  formation  of  the  excrement,  is  ren- 
dered possible.  Health  is  recognised  by  the  regular  action 
of  this  archeus. 

A  striking  similarity  with  the  doctrines  of  Darwin  is 
found  in  the  view  of  Paracelsus  that  the  origin  of  every- 
thing is  simply  the  transformation  of  germs  always  exist- 


THE  CLOSE  OF  MEDIEVALISM  173 

ing  (and  therefore  is  a  metamorphosis),  as  well  as  in  the 
fact  that  he  maintained  that  every  object  and  being  origi- 
nated at  the  expense  of  and  through  the  destruction  of 
another,  a  doctrine  in  which  is  seen  already  developed  the 
war  of  individual  against  individual  and  the  struggle  for 
existence  so  much  talked  about  nowadays. 

Upon  anatomy  in  the  modern  sense  of  the  term — he  calls 
it  local  anatomy — Paracelsus  laid  no  weight  so  far  as  con- 
cerns internal  disease.  He  opposes  to  it  a  universal  an- 
atomy which  the  physician  must  know  in  order  to  cure  and 
to  understand  diseases.  Under  this  universal  (or  general) 
anatomy  he  understands  the  separation  into  that  triad  of 
fundamental  bodies — salt,  sulphur,  mercury — of  which  the 
body  consists,  as  well  as  the  knowledge  of  the  nature  and 
power  of  an  object  and  of  its  celestial  model.  In  attempt- 
ing to  explain  the  phenomenon  of  life  he  mixed  philosophy, 
alchemy  and  physiology.  He  believed  that  sulphur  repre- 
sented combustible  elements  in  things,  salt  the  soluble  and 
mercury  the  volatile  elements.  He  thus  supported  the 
theories  of  Valentine,  for  he  too  was  a  skilled  alchemist. 

The  parts  of  the  body  stand  in  reciprocal  relation  with 
the  stars,  and,  in  fact,  the  seven  great  organs — the  brain, 
heart,  lungs,  gall,  kidneys  and  spleen — correspond  to  the 
moon,  the  sun,  Mercury,  Mars,  Jupiter,  Venus  and  Saturn. 
Furthermore,  he  makes  seven  kinds  of  pulses  as  there  are 
seven  planets.  Epilepsy  resembles  the  earthquake;  apo- 
plexy the  lightning ;  flatulence  the  wind-storm ;  dropsy,  in- 
undations ;  the  chilliness  of  fever,  the  quaking  at  the  origin 
of  new  worlds.  Fever  in  itself,  according  to  his  views,  is 
an  effort  of  the  healing  power  of  nature  to  equalize  the 
disturbances  of  the  body;  that  is,  to  cure.  Paracelsus 
divided  diseases  into  material  and  spiritual,  acute  and 
chronic. 

The  doctrines  which  he  taught  with  such  zeal  were  in 
the  main  the  doctrines  of  Valentine,  but  enlarged  and  de- 
veloped by  the  new  light  which  he  had  gained  by  his  own 
researches  and  studies.  He  discovered  many  new  chemical 


174  MEDICINE 

bodies  and  introduced  many  new  remedies.  To  him  is 
largely  due  the  spread  of  that  drug,  which  perhaps  more 
than  any  one  drug  has  influenced  the  fortunes  of  mankind 
— namely,  laudanum,  the  use  of  which  is  said  to  have  been 
due  to  him.  He  was  emphatically  not  an  anatomist,  not  a 
physiologist,  but  a  pharmacologist.  He  paid  little  heed  to 
the  doctrines  of  Galen  and  cared  little  or  nothing  for  an- 
atomy. He  was  a  chemist  to  the  backbone  and  his  pathol- 
ogy was  based  not  on  changes  of  structure  and  their 
attendant  symptoms  but  on  the  relation  of  diseases  to 
drugs.  He  insisted  that  diseases  ought  to  be  known  by  the 
names  of  the  drugs  which  cured  them — morbus  hellebori- 
nus  and  the  like.  In  this  he  was  a  forerunner  of  an  errant 
school  of  the  therapeutics  in  modern  times. 

He  believed  that  the  color  and  physical  properties 
of  drugs  should  correspond  somewhat  to  the  locality  and 
nature  of  the  disease.  As  in  the  case  of  diseases  of  the 
eye,  one  should  use  euphrasia,  because  the  black  spot  on 
that  flower  points  the  pupil  of  the  eye.  Also  gold  must 
be  used  in  diseases  of  the  heart  because  gold,  according  to 
cabalistic  assumption,  harmonizes  with  the  heart.  He  was 
cautious  in  the  use  of  venesection,  but  performed  it  when 
his  astrological)  ideas  permitted  it. 

The  reform  in  surgery  and  its  practice  during  the  six- 
teenth century  was  the  result  not  only  of  the  change  in 
the  instruments  used  in  warfare,  but  also  of  the  impulse 
that  had  been  given  to  the  direct  study  of  human  anatomy. 
Altho  the  old-fashioned  weapons  were  still  employed,  fire- 
arms and  cannon  were  fast  taking  their  places,  and  the 
wounds  were  of  a  more  complex  nature,  demanding  of  the 
physician  and  surgeon  a  more  intimate  knowledge  of  the 
structures  which  had  been  wounded.  This  transformation 
of  surgical  after-treatment  was  the  work  of  a  single  man, 
who  so  changed  the  prevailing  methods  of  technique  that 
those  following  in  succeeding  years  began  at  once  the  up- 
lifting of  surgery  to  the  foremost  position  which  it  to-day 
occupies. 


THE  CLOSE  OF  MEDIEVALISM  175 

Ambroise  Pare  (1510-1590)  was  the  son  of  a  barber  and 
followed  in  his  father's  footsteps  by  being  first  a  barber. 
When  he  had  become  a  barber-surgeon  at  nineteen  he  went 
to  war  as  an  army  surgeon  and  there  spent  many  years  on 
the  battlefields,  the  best  school  of  surgery.  Altho  by  no 
means  learned,  he  was  most  gifted,  being  an  essentially 
practical  physician.  His  fame  became  so  great  that  he  was  , 
appointed  as  one  of  the  twelve  royal  surgeons  and  he  was 
made  a  member  of  the  great  exclusive  College  de  St. 
Come,  whose  professors  even  overlooked  the  fact  that 
he  knew  no  Latin.  Truly  a  great  honor.  The  chief  work 
of  Pare  was  not  the  result  of  any  inspiration,  but  was 
more  or  less  an  accident.  Gunshot  wounds  up  to  this  time 
had  always  been  considered  poisoned  and  the  treatment  of 
such  was  to  destroy  the  dangerous  poisons.  This  was  con- 
sidered to  be  best  done  by  cauterizing  the  wound  with 
boiling  oil.  After  a  rather  heavy  day's  fighting,  in  which 
many  men  had  been  wounded  and  were  lying  in  the  hospital 
tents  awaiting  their  time  for  the  prescribed  treatment 
(there  were  no  anesthetics  used  in  those  days),  Pare  found 
that  his  supply  of  oil  had  run  short  and  that  he  could  get 
no  more  for  some  days. 

The  knowledge  of  this  fact  upset  and  alarmed  him  a 
great  deal,  for  he  saw  nothing  but  death  for  the  untreated 
soldiers.  These  he  was  compelled  merely  to  dress  with 
clean  cloths.  Pare  retired  to  bed  that  night,  a  tired  and 
anxious  man.  The  next  morning  he  sought  out  without 
delay  the  men  expected  to  die  shortly,  but  what  was  his 
amazement  and  delight  to  find  that  they  were  all  in  far 
better  condition  than  their  comrades  who  had  been  sub- 
jected to  the  routine  treatment  with  boiling  oil !  They 
suffered  less  pain,  had  fewer  general  symptoms,  hence 
were  more  comfortable  and  the  wounds  were  in  better 
shape,  there  being  less  inflammatory  reaction  in  them. 
Pare  at  once  introduced  this  new  idea  into  his  treatment 
of  wounds  and  began  immediately  to  obtain  much  better 
results.  As  soon  as  he  was  himself  positive  of  the  superi- 


176  MEDICINE 

ority  of  this  new  method  of  treating  gunshot  wounds  he 
wrote  a  treatise  on  the  results  of  his  great  discovery,  thus 
promoting  surgery  not  only  in  France  but  throughout  the 
world. 

Another  great  achievement  of  Pare  was  the  recom- 
mendation and  practice  of  ligation  of  arteries  when  divided 
and  bleeding.  Altho  this  had  frequently  been  done  by  the 
ancients  and  the  Arabians,  it  had  been  dropped  and  sup- 
planted by  the  red-hot  cautery.  Pare  discovered  it  quite 
independently  and  deserves  more  credit  because  he  applied 
it  in  the  practice  of  amputation.  In  regard  to  amputa- 
tions he  was  also  a  pioneer,  for  he  excised  a  limb  not 
through  gangrenous  and  diseased  tissues  but  above  those 
areas,  through  the  sound  and  healthy  tissues,  thus  favoring 
the  chance  for  primary  healing  without  the  formation  of 
pus  and  infection.  It  is  interesting  to  note  that  when  large 
blood-vessels  were  ligated  the  surgeons  took  great  care  to 
include  the  nerves  in  the  ligature,  thinking  thus  to  prevent 
the  escape  of  any  vital  spirits  !  Pare  was  the  first  surgeon 
to  use  to  any  extent  trusses  for  the  reduction  of  ruptures 
(or  hernias).  He  introduced  many  new  plastic  operations 
for  deformities  and  invented  feeding-bottles  for  the  arti- 
ficial feeding  of  infants  with  cows'  milk. 

In  England  two  physicians  of  high  rank — Linacre  and 
John  Kaye — freed  English  medicine  from  the  control  of 
the  clergy  and  at  the  same  time  laid  the  foundation  for 
the  self-government  of  the  English  physicians. 

As  the  new  varieties  of  wounds  necessitated  a  more 
thorough  investigation  and  knowledge  of  anatomy,  that 
subject  began  to  be  developed  extensively.  As  Baas  points 
out  in  his  complete  'History  of  Medicine/  serious  errors, 
handed  down  from  antiquity,  proved  genuine  hindrances 
to  a  far  grander  advancement.  Such  was  the  Galenic  doc- 
trine that  the  arteries,  since  they  were  empty  in  the 
cadaver,  contained  only  the  vital  spirits,  and  that  the  veins 
alone  contained  blood ;  that  the  blood  flowed  forward  in  the 
veins  during  inspiration  and  backward  in  expiration,  with- 


THE   CLOSE   OF  MEDIEVALISM  177 

out  returning  to  the  heart,  and  was  entirely  consumed  in 
the  processes  of  nutrition. 

It  was  in  this  sixteenth  century  that  Galen's  long  hold 
on  anatomy  was  broken.  In  this  work  Vesalius  took  the 
lead,  and  it  is  due  to  him  primarily  that  anatomy  was  com- 
pletely reformed,  thus  laying  the  foundations  for  physi- 
ology and  pathological  anatomy,  both  to  be  built  up  very 
soon. 

Andreas  Vesalius  (1514-1564)  was  the  first  to  declare 
that  Galen's  anatomy  was  based  not  upon  human,  but  upon 
animal  dissection.  He  proved  his  statement  positively  by 
many  careful  dissections  and  demonstrations  upon  the 
human  body.  He  was  the  first  to  employ  wood-cuts,  made 
after  Nature,  in  the  illustration  of  his  anatomical  books. 
At  the  age  of  twenty-three  years  he  was  made  professor 
of  anatomy  at  Padua.  He  at  once  began  to  teach  anatomy 
in  his  own  new  way.  Not  to  unskilled,  ignorant  barbers 
would  he  entrust  the  task  of  laying  bare  before  the  students 
the  secrets  of  the  human  frame ;  his  own  hand,  and  his 
own  hand  alone,  was  cunning  enough  to  track  out  the 
pattern  of  structures  which  day  by  day  were  becoming 
more  and  more  clear  to  him. 

Following  venerated  customs,  he  began  his  academic 
labors  by  'reading'  Galen,  as  others  had  done  before  him, 
using  his  dissections  to  illustrate  what  Galen  had  said.  But 
time  after  time  the  body  on  the  table  said  plainly  some- 
thing different  from  that  which  Galen  had  written.  He 
tried  to  do  what  others  had  done  before  him;  he  tried  to 
believe  Galen  rather  than  his  own  eyes,  but  his  eyes  were 
too  strong  for  him,  and  in  the  end  he  cast  Galen  and  his 
writings  to  the  winds  and  taught  only  what  he  himself 
had  seen  and  what  he  could  make  his  students  see  too. 

Vesalius'  great  work  is  a  work  of  anatomy,  not  of  physi- 
ology. Tho  to  almost  every  description  of  structure  there 
are  added  observations  on  the  use  and  functions  of  the 
structures  described,  and  tho  at  the  end  of  the  work  there 
is  a  short  special  chapter  on  what  is  now  called  experi- 


178 


MEDICINE 


mental  physiology,  the  book  is  in  the  main  a  book  of 
anatomy.  The  physiology  is  incidental,  occasional  and  in- 
deed halting.  Nor  is  the  reason  far  to  seek.  Vesalius  had 
a  great  and  difficult  task  before  him.  He  had  to  convince 
the  world  that  the  only  true  way  to  study  the  phenomena  of 
the  living  body  was,  not  to  ask  what  Galen  had  said,  but 
to  see  for  one's  self,  with  one's  eyes,  how  things  really 


fib  - 


Fig.   7 — KNEE-JOINT  AND   BICEPS   MUSCLE;   FIRST   DESCRIBED  BY 

VESALIUS 
Outer  half  of  femur  and  patella  sawn   away ;   fern.,   femur ;   tib.. 

tibia;  fib.,  fibula;  caps.,  capsule  of  joint;  1,  crucial  ligaments; 

c,  semilunar  fibro.-cartilages ;  e,  tendon  of  extensor  muscle. 
Arm,  showing  shortening  of  muscle  by  which  a  weight  is  lifted. 

were.  And  not  only  was  a  sound  and  accurate  knowledge 
of  the  facts  of  structure  a  necessary  prelude  to  any  sound 
conclusions  concerning  function,  but  also  the  former  was 
the  only  safe  vantage  ground  from  which  to  fight  against 
error.  When  he  asserted  that  such  a  structure  was  not  as 
Galen  had  described  it,  but  different,  he  could  appeal  to 
the  direct  visible  proof  laid  bare  by  the  scalpel. 


THE  CLOSE  OF  MEDIEVALISM  179 

Almost  everywhere  Vesalius  placed  himself  in  express 
opposition  to  Galen.  Thus  he  denied  the  existence  of  the 
'os  intermaxillare'  in  adults  and  the  composition  of  the 
inferior  maxilla  of  two  bones.  In  like  manner  he  reduced 
Galen's  seven  bones  of  the  sternum  to  three  and  gave  to 
the  sacrum  (and  coccyx)  five  or  six  pieces,  instead  of  the 
three  of  Galen.  In  opposition  to  the  latter,  Vesalius  also 
established  the  existence  of  marrow  in  the  bones  of  the 
hand  and  refuted  his  assumption  of  an  imputrescible  bone 
of  the  heart,  as  well  as  his  assertion  of  the  strong  curvature 
of  the  bones  of  the  upper  arm  and  the  thigh.  He  main- 
tained that  nerves  and  muscles  stood  in  no  relation  of  pro- 
portionate strength  to  each  other,  for  that  stout  nerves 
were  distributed  to  small  muscles  and  conversely ;  that  the 
tendons  were  similar  in  constitution  to  the  ligaments  and 
not  to  the  muscles,  that  the  latter  were  in  some  respects 
independent. 

Vesalius  denied  the  existence  of  a  general  muscle  of  the 
skin,  proved  that  the  intercostal  muscles  merely  separate 
the  ribs  from  each  other,  without  either  expanding  or 
contracting  the  thorax,  and  discarded  the  origin  of  the 
vena  cava  inferior  from  the  liver,  all  in  opposition  to 
Galen.  He  first  described  the  course  of  the  vena  azygos 
and  the  subclavian  vein,  the  ductus  venosus;  gave  a  de- 
scription of  the  structure  of  the  ear,  the  sphenoid  bone  of 
the  head,  the  mediastinum,  the  peritoneum  and  omentum 
and  many  of  the  abdominal  organs.  Of  course  Vesalius 
was  no  more  exempt  than  any  other  man  from  individual 
errors  and  those  of  his  own  and  the  past  age.  Thus  in 
his  view  the  veins  alone  were  blood-vessels,  while  the  ar- 
teries were  still  carriers  of  the  vital  spirits  and  simply 
appendages  of  the  veins. 

Even  in  this,  which  he  ventured  to  print,  the  sarcastic 
note  of  skepticism  made  itself  heard,  but  what  he  really 
thought  he  did  not  dare  to  put  forward.  He  tells  us  in  a 
later  writing  that  "he  accommodated  his  statements  to 
the  dogmas  of  Galen,"  not  because  he  thought  that 


i8o  MEDICINE 

"These  were  in  all  cases  consonant  with  truth  but 
because  in  such  a  new,  great  work  he  hesitated  to  lay 
down  his  own  opinions,  and  did  not  dare  to  swerve  a 
nail's  breadth  from  the  doctrines  of  the  Prince  of 
Medicine." 

That  physiological  problems  were  before  his  mind,  that 
he  had  thought  over  and  indeed  had  tried  to  solve  them  by 
experimental  methods,  is  shown  in  the  brief  chapter, 
'Some  Remarks  on  the  Vivisection  of  Animals/  which  is 
the  last  chapter  in  his  great  work.  In  this  he  relates  his 
experiments  on  muscle  and  nerve,  showing  that  which 
passes  along  a  nerve  in  order  to  bring  about  movement 
passes  by  the  substance  and  not  by  the  sheath  of  the 
nerves.  He  affirms  that  it  is  through  the  spinal  cord  that 
the  brain  acts  on  the  trunk  and  limbs;  that  an  animal  can 
live  after  its  spleen  has  been  removed;  that  the  lungs 
shrink  when  the  chest  is  punctured;  that  the  voice  is  lost 
when  the  recurrent  laryngeal  nerve  is  cut;  that  by  arti- 
ficial respiration  an  animal  can  be  kept  alive,  tho  its  chest 
is  laid  wholly  bare,  and  that  under  these  circumstances  a 
heart  which  has  almost  stopped  beating  may  be  revived 
by  the  timely  use  of  the  bellows. 

Vesalius'  results  were  impugned  and  indeed  were  cor- 
rected by  his  compeers  and  his  followers,  but  they  were 
impugned  and  corrected  by  the  method  which  he  had  in- 
troduced. Inquirers  asserted  that  in  this  or  that  point 
Galen  was  right  and  Vesalius  was  wrong,  but  they  no 
longer  appealed  to  the  authority  of  Galen  as  deciding  the 
question;  they  appealed  now  to  the  actual  things  as  the 
judge  between  the  two.  And  even  those  who  were  Vesalius' 
rmost  devoted  disciples  never  made  of  him  a  second  Galen ; 
they  never  appealed  to  him  as  an  authority,  for  they  were 
•content  to  show  on  the  actual  body  that  what  he  had  said 
"was  right. 

Under  a  inore  special  aspect  he  may  be  regarded  as  the 
founder  of  physiology  as  well  as  of  anatomy,  inasmuch  as 
jphysiology  is  based  upon  anatomy,  and  he  was  the  distinct 


THE  CLOSE  OF  MEDIEVALISM  181 

forerunner  of  Harvey,  for  Harvey's  great  exposition  of  the 
circulation  of  the  blood  did,  as  will  be  seen,  for  physiology 
what  Vesalius'  "Fabrica"  did  for  anatomy;  it  first  ren- 
dered true  progress  possible.  And  Harvey's  great  work 
was  the  direct  outcome  of  Vesalius'  teaching,  the  direct 
outcome  and  yet  one  reached  by  successive  steps,  steps 
taken  by  men  of  the  Italian  school,  of  which  Vesalius  was 
the  founder  and  father. 

Pathological  anatomy  had  its  beginning,  small  as  it  was, 
in  this  century,  and  it  grew  naturally  as  a  result  of  the 
great  anatomical  zeal.  It  began  really  as  a  search  for 
curiosities  and  gross  abnormalities.  The  horror  and  dread 
of  dissecting  and  thus  defiling  the  dead  were  fast  being 
stamped  out,  especially  in  the  minds  of  earnest  medical 
students,  who  had  profited  by  Vesalius'  great  rebellion 
against  the  anatomy  of  Galen.  The  human  body  was 
searched  for  stones  and  concretions,  which  were  found  in 
the  kidneys,  bladder,  lungs,  gall-bladder,  brain  and  other 
places,  thus  further  deciding  against  Galen,  for  he  insisted 
that  there  could  be  stones  only  in  the  kidney  and  bladder. 
Servetus,  an  anatomist  of  a  few  years  later,  was  the  first 
to  teach  that  the  septum  between  the  chambers  of  the 
heart  was  not  perforated,  as  had  been  advocated.  In  his 
"Restitutio  "  occurs  this  remarkable  passage: 

"In  order,  however,  that  we  may  understand  how 
the  blood  is  the  very  life,  we  must  first  learn  the  gen- 
eration in  substance  of  the  vital  spirit  itself  which  is 
composed  and  nourished  out  of  the  inspired  air  and 
very  subtle  blood.  The  vital  spirit  has  its  origin  in 
the  left  ventricle  of  the  heart,  the  lungs  especially 
helping  toward  its  perfection ;  it  is  a  thin  spirit,  elab- 
orated by  the  powers  of  heat,  of  a  yellow  (light) 
color,  of  a  fiery  potency  so  that  it  is,  as  it  were,  a 
vapor  shining  out  of  the  blood,  containing  the  sub- 
stance of  water,  of  air,  and  of  fire.  It  is  generated 
through  the  commingling  which  is  effected,  in  the 
lungs,  of  the  inspired  air,  with  the  elaborated  subtle 


182  MEDICINE 

blood  communicated  from  the  right  ventricle  to  the 
left.  That  communication  does  not,  however,  as  is 
generally  believed,  take  place  through  the  median 
wall  (septum)  of  the  heart,  but  by  a  signal  artifice 
the  subtle  blood  is  driven  by  a  long  passage  through 
the  lungs.  It  is  prepared  by  the  lungs,  is  rendered 
yellow  (light)  and  passes  from  the  artery-like  vein. 
In  the  vein-like  artery  it  is  mixed  with  the  inspired 
air,  and  by  the  expiration  is  cleansed  from  its  fumes. 
And  so  at  length  it  is  drawn  in,  a  complete  mixture, 
by  the  left  ventricle  through  the  diastole,  stuff  fit  to 
become  the  vital  spirit. 

"That  the  communication  and  preparation  does  take 
place  in  this  way  through  the  lungs  is  shown  by  the 
manifold  conjunction  and  communication  of  the 
artery-like  vein  with  the  vein-like  artery.  This  view 
is  confirmed  by  the  conspicuous  size  of  the  artery-like 
vein  which  would  not  have  been  made  so  large  and  so 
stout,  and  would  not  discharge  from  the  heart  itself 
such  a  power  of  very  pure  blood  into  the  lungs  for 
the  mere  purpose  of  nourishing  these  organs.  Nor 
would  the  heart  serve  the  lungs  in  this  manner,  es- 
pecially since  at  an  earlier  date  in  the  embryo  on 
account  of  the  little  membranes  of  the  heart,  the  lungs 
themselves  are  up  to  the  hour  of  birth  nourished  from 
other  sources,  as  Galen  teaches." 

These  words  show  beyond  all  possible  doubt  that 
Servetus  rejected  wholly  and  unreservedly  the  hypothetical 
passage  of  the  blood  through  the  septum;  he  went  far 
beyond  the  merely  hinted  skepticism  of  Vesalius.  They 
further  show  that  he  had  grasped  the  true  features  of  the 
pulmonary  circulation,  the  passage  of  the  blood  from  the 
right  side  through  the  lungs  to  the  left  side.  He  must 
have  attained  these  results  by  his  own  unaided  inquiry 
and  thought ;  and  had  he  given  to  science  the  labors  which 
he  gave  to  theology,  he  might  have  deserved  the  title  of 
one  of  the  great  physiologists  of  the  time. 


THE  CLOSE  OF  MEDIEVALISM  183 

Servetus'  only  obscure  point  in  his  theory  of  the  lesser 
circulation,  as  the  pulmonary  circulation  is  called,  is  that 
the  blood  returning  from  the  lungs  to  the  heart,  through 
the  pulmonary  veins,  contained  pneuma  (air)  and  blood. 
A  few  years  later,  however,  this  idea  was  dispelled  by 
Colombo,  who  demonstrated,  by  experiment,  that  the  pul- 
monary veins  contained  blood  only.  Cesalpino,  a  pupil 
of  Colombo,  came  nearest  to  Harvey  in  describing  the 
lesser  circulation  perfectly,  saying  that  the  blood  anasto- 
mosed from  arteries  to  veins  in  the  lungs;  that  the  blood 
was  cooled  in  the  lungs,  and  that  no  air  was  in  the  blood. 
Yet  he  admitted  the  existence  of  pores  in  the  wall  of  the 
heart.  He  also  held  some  correct  views  concerning  the 
greater  circulation. 

For  the  performance  of  all  dissections  in  the  universi- 
ties (they  were  still  prohibited  by  the  Church)  papal 
indulgences  were  necessary,  and  these,  of  course,  cost 
money.  Tubingen  received  such  an  indulgence  as  early  as 
1482,  while  in  Strassburg,  in  spite  of  papal  prohibition, 
permission  to  dissect  an  executed  criminal  was  granted  by 
the  magistrates  in  1517.  Before  and  after  each  special 
dissection  (which  was,  however,  a  relatively  infrequent 
occurrence)  religious  ceremonies  in  many  places  were  con- 
sidered necessary.  In  order  that  those  who  came  into  con- 
tact with  it  might  not  become  'disreputable/  the  corpse  was 
first  made  'reputable/  the  professor  beginning  the  proceed- 
ings by  reading  a  decree  to  that  effect  from  the  lord  of 
the  land,  and  then,  by  order  of  the  Senate  or  the  medical 
faculty,  stamping  upon  its  breast  the  seal  of  the  university. 

The  body  was  then  carried  (upon  the  cover  of  the  box 
in  which  it  had  been  brought  in)  by  volunteers  for  this 
service  into  the  anatomical  hall,  and  the  cover,  upon  which 
it  rested  during  these  ceremonies,  was  then  taken  back  to 
the  executioner,  who  had  meanwhile  remained  at  some 
distance  with  his  vehicle.  Afterward  entertainments, 
graced  with  music  by  the  guilds  of  city  fifers,  trumpeters, 
trombone  players,  etc.,  or  by  "itinerant  actors,"  were  given. 


184  MEDICINE 

Gradually,  however,  this  folly  waned,  and  in  the  second 
half  of  the  century,  public  anatomical  theaters  were  estab- 
lished. Such  a  theater  was  built  by  Fabricius  ab  Aqua- 
pendente  in  Padua  (the  most  popular  and  famous  medical 
institution  of  the  sixteenth  century),  at  his  own  expense, 
in  1549.  The  price  of  a  skeleton  in  that  day  was  very 
high.  Thus  Heidelberg  in  1569  paid  $72  for  a  single  skele- 
ton, an  immense  sum  in  ancient  values. 

The  higher  physicians,  usually  of  the  laity  and  not 
clergy,  received  their  education  in  the  universities.  The 
Italian  were  the  best,  altho  France  and  Germany  had 
excellent  schools.  The  students,  especially  in  upper  Italy, 
were  so  strong  and  large  a  community  in  themselves,  that 
they  controlled  the  university,  both  its  curriculum  and 
the  appointment  of  its  professors.  The  poorer  students 
were  known  as  "Traveling  Students."  They  traveled  from 
first  one  Latin  school  to  another,  gradually  becoming 
more  and  more  fitted,  and  thus  advanced  themselves  to 
the  best  university.  They  traveled  in  bands  or  groups, 
and  during  their  pilgrimages,  the  worst  sort  of  atrocities 
and  crimes  were  committed.  They  supported  life  in  many 
ways,  by  singing,  begging  and  stealing.  The  "traveling" 
began  in  eafly  youth,  and  for  many  students  never  came 
to  an  end.  Some  few  of  them  became  great  men,  but  most 
of  them  fell  into  dissolute  and  vicious  lives. 

The  physicians  of  this  century  were  quite  as  roving  as 
the  students  and  professors.  Surgery  was  largely 
neglected,  as  unbecoming  a  gentleman,  so  that  it  was 
relegated  to  a  lower  class  of  practitioners.  The  self- 
satisfied  literati  considered  it  an  important  part  of  their 
business  to  consult  the  stars  for  proper  time  to  bleed  and 
purge  a  patient.  In  general,  the  physicians  of  the  so- 
called  "long-robes"  enjoyed  considerable  respect,  but  they 
never  treated  the  masses,  not  only  because  they  did  not 
want  to,  but  also  because  the  poor  people  were  not  ad- 
vanced enough  to  go  to  them. 


CHAPTER  VI 

THE  CENTURY   OF   SCHOOLS 

THE  seventeenth  was  the  "Century  of  Schools/'  the 
outgrowth  of  the  adoption  into  medical  science  of  acces- 
sory natural  sciences  such  as  physics  and  chemistry.  Ger- 
many, involved  in  the  great  thirty  years'  religious  war, 
was  not  able  to  advance  in  the  sciences  as  she  had  done  in 
the  preceding  century,  so  other  countries  took  the  lead, 
especially  England  and  Italy.  The  sixteenth  century  had 
been  idealistic,  but  in  the  seventeenth,  modern  realism  in 
all  departments  of  thought  was  developed,  and  in  the 
adoption  of  the  natural  sciences,  often  to  an  extreme  de- 
gree, medicine  gave  the  first  instance  of  the  modern 
"exact"  method.  Hence  this  century  is  called  the  greatest 
in  the  development  of  medicine.  As  the  accessory  sciences 
developed  more  and  more,  they  acquired  an  influence  over 
and  control  of  medicine  proper  to  an  alarming  extent. 
Physicists  and  chemists  took  control  of  medicine,  not  only 
in  trying  to  theorize  and  explain  life's  phenomena,  but 
even  to  the  extent  of  dictating  methods  of  treatment,  the 
real  purpose  of  medicine  being  lost  sight  of — that  is,  the, 
cure  of  disease  and  alleviation  of  human  suffering. 

One  of  the  greatest  inventions  ever  made,  and  one  of 
especial  importance  in  the  advance  of  the  medical  sciences, 
was  that  of  the  microscope  by  Jansen  in  1620.  Other  in- 
ventions, such  as  the  thermometer,  besides  many  discov- 
eries of  natural  laws  in  physics  and  astronomy,  had  no 
little  influence  on  the  advancement  of  medicine.  The 

185 


i86  MEDICINE 

natural  sciences  became  separated  in  this  century  from 
philosophy  and  religion,  and  became  founded  upon  the 
correct  basis  of  observation  and  experimentation.  Zoology 
and  botany,  after  the  discovery  of  the  microscope,  made 
rapid  advances,  also  having  their  influences  on  anatomy, 
both  normal  and  pathological.  The  first  classification  of 
plants  led  to  the  effort  to  study  diseases  in  a  similar 
manner. 

The  influences  of  preceding  centuries  was  still  felt,  but 
it  had  been  so  broken,  that  only  in  certain  quarters  could 
it  wreak  harm.  Altho  Galen  and  the  Arabians,  and  even 
Hippocrates,  made  themselves  felt  here  and  there,  Par- 
acelsus possessed  by  far  the  largest  number  of  disciples. 
The  doctrines  of  this  mystic  and  pietist  were  gathered 
by  Van  Helmont  into  a  system  based  upon  chemical  prin- 
ciples. The  latter  was  a  true  son  of  his  century,  a  mystic 
and  at  the  same  time,  a  realist.  He  studied  mathematics, 
astronomy,  philosophy,  medicine  and  chemistry,  vacil- 
lating from  one  to  the  other.  The  system  which  he 
founded  was  not  an  enduring  one,  and  he  had  only  a  few 
followers.  In  his  doctrine  of  the  elements,  he  differs 
from  the  ancients  and  from  Paracelsus,  in  regarding  air 
and  water  as  elements,  and  held  that  from  water,  every- 
thing on  earth  takes  its  origin.  Man  has  a  soul,  command- 
ing a  spirit  called  the  "Archeus,"  which  exists  also  in 
lower  animals.  Besides  these,  there  is  also  "gas,"  which 
arises  from  the  action  of  the  Archeus  on  the  water.  The 
active  principle  of  the  Archeus,  both  in  health  and  disease, 
is  a  ferment.  The  "ferment"  is  the  chief  agent  in  diges- 
tion, adheres  to  the  acid  of  the  stomach,  and  obeys  the 
commands  of  the  Archeus. 

Deeply  impressed  with  this  idea  of  the  action  of  fer- 
ments, Van  Helmont  makes  it  the  basis  of  his  system  of 
physiology.  Nearly  all  the  writers  before  him  had  caught 
hold  of  the  phenomena  of  the  fermenting  wine-vat,  as 
being,  though  mysterious  in  themselves,  illustrative  of  the 
still  more  mysterious  phenomena  of  the  living  body;  and 


THE  CENTURY  OF  SCHOOLS  187 

the  old  idea  of  the  physiological  spirits  of  the  body,  nat- 
ural, vital  and  animal,  was  connected  in  its  origin  with 
this  same  formation  of  alcohol,  of  spirits  of  wine  by 
fermentation. 

His  exposition  of  physiology  is  based  on  the  theory  of 
fermentations.  The  ordinary  vinous  fermentation  gives 
him  his  initial  idea;  following  this  up,  he  regards  all  the 
changes  in  the  body  (not  digestion  only,  but  also  others, 
including  nutrition,  impregnation  and  even  movements) 
as  due  to  the  action  of  ferments. 

He  assumes  the  current  teaching  of  the  day  to  be  (i) 
that  the  food  absorbed  from  the  stomach  and  intestine 
is  in  the  liver  endued  with  natural  spirits,  (2)  that  in  the 
heart  the  natural  spirits  are  converted  into  vital  spirits, 
and  (3)  that  in  the  brain  the  vital  spirits  are  converted 
into  animal  spirits.  He  claims  there  are  six  different 
grades  of  digestion,  corresponding  to  the  days  of  creation. 

In  accordance  with  these  cosmogenetic  and  physiologi- 
cal views,  Helmont  in  his  general  pathology  considers 
disease  something  active,  not  simply  an  impairment  or 
loss  of  health.  The  general  cause  of  disease  is  the  fall 
of  man.  As  regards  special  pathology,  disease  depends 
upon  a  perverted  action  of  the  Archeus,  upon  morbid 
ideas,  or  upon  errors  of  the  Archeus,  as  the  result  of 
which  it  sends  the  ferment  of  the  stomach  to  improper 
places.  These  morbid  ideas  of  the  Archeus  arise,  how- 
ever, from  its  anxiety,  dread,  hate,  terror,  anger,  or  pas- 
sion. Fever  is  an  expression  of  the  sensibility  of  the 
Archeus  injured  by  the  cause  of  the  fever.  The  period  of 
chill  is  the  expression  of  its  passion  or  terror;  the 
stadium  of  heat,  that  of  its  fury.  On  the  other  hand, 
inflammation  originates  in  a  "spina"  (irritation),  which 
springs  from  excitation  of  the  Archeus,  or  from  external 
causes.  Among  the  occasional  causes  of  diseases  Van 
Helmont  ranks  demons,  witches,  ghosts,  necromancers, 
and  similar  weird  forms. 

Van  Helmont's  special  etiology  gives  as  the  cause  of 


i88  MEDICINE 

dropsy,  hindrance  to  the  excretion  of  urine  by  the  enraged 
Archeus.  In  inflammation  of  the  chest,  where,  he  says, 
the  blood  coagulates  outside  of  the  vessels,  the  Archeus 
sends  the  acid  secretion  of  the  stomach  into  the  lungs ; 
in  gout,  into  the  joints,  etc.  In  catarrh  the  mucus  is 
formed  from  the  remnants  of  the  food  sticking  to  the 
palate;  vesical  calculi  originate  in  a  deposit  of  the  urinary 
salts.  "Putrefaction"  in  the  closed  lumen  of  the  vessels 
he  does  not  recognise  as  the  cause  of  disease  in  fevers. 
Altho  Van  Helmont  made  local  diseases  so  very  prominent 
in  his  system,  and  therefore  desired  to  improve  the  con- 
dition of  pathological  anatomy,  still,  like  Paracelsus,  he 
placed  no  value  upon  normal  anatomy.  Surgery  he 
claimed  to  be  inseparable  from  medicine. 

Altho  in  therapeutics  Van  Helmont  laid  great  weight 
on  universal  medicine,  conjurations,  charms  and  prayer, 
and  in  his  pious  style  claimed  God's  mercy  as  the  basis  of 
the  efficacy  of  medicines,  yet  he  did  not  despise  earthly 
remedies,  whose  active  principles  are  contrasted  with  the 
chemical  constituents.  He  gives  opium  (to  the  stimulant 
effect  of  which,  for  the  first  time,  he  called  attention), 
mercury,  antimony  and  wine  in  fevers  (alcoholic  treat- 
ment of  fevers),  and  makes  frequent  use  of  Arcana.  The 
latter,  in  his  view,  are  to  be  considered  specifically  active 
against  the  wrathful,  or  in  any  way  excited  Archeus, 
against  whose  discontent  and  ill-humor  and  morbid  ideas 
in  general,  all  therapeutics  were  to  be  directed;  while  the 
remedies  first  mentioned,  espcially  those  of  metallic  origin, 
act  in  a  similar  way,  only  not  specifically. 

In  general  he  lays  stress  upon  simple  chemical  remedies, 
and  abhors  bleeding  because  of  its  tendency  to  debilitate, 
a  tendency  to  which  he  first  called  attention.  In  the 
colossal  abuse  of  bleeding  which  prevailed  at  this  time, 
his  caution  on  this  subject  merits  every  commendation. 
In  the  calendars,  bleeding,  according  to  the  rules  of 
astrology,  was  preached  as  a  general  prophylactic  until 
the  opening  of  the  present  century. 


THE  CENTURY  OF  SCHOOLS  189 

The  medical  studies,  in  which  Van  Helmont  first  found 
something  solid  to  rest  upon,  were  not  the  vague  Galenic 
teachings  which  were  all  that  had  been  offered  to  Para- 
celsus, but  teachings  based  on  the  exact  anatomical  knowl- 
edge provided  by  Vesalius  and  his  school,  and  on  all 
which  that  knowledge  carried  with  it.  By  gas,  he  meant, 
and  by  the  introduction  of  the  new  term  indicates  his 
appreciation  of  the  discovery  of,  what  is  now  called 
carbonic  acid  gas,  or  carbon  dioxide;  and  the  develop- 
ment of  a  great  deal  of  chemistry,  and  especially  of  the 
chemistry  of  living  beings,  has  turned  on  the  nature  and 
properties  of  gases. 

It  was  in  relation  to  this  gas  that  Van  Helmont  parts 
company  with  Paracelsus.  He  argues  that  Paracelsus 
was  wholly  wrong  in  maintaining  that  sulphur,  mercury 
and  salt  were  the  three  elements.  There  are,  he  con- 
tends, two  elements  only,  air — that  is  to  say,  the  natural  at- 
mosphere— and  water.  He  spends  much  time  in  proving 
that  air  and  water  can  never  be  changed,  the  one  into  the 
other;  that  they  are  distinct  and  never  convertible;  that 
the  vapor  of  water  is  something  wholly  different  from 
real  air.  On  the  other  hand,  by  what  he  called  water,  he 
meant  everything  which  is  not  air;  he  insists  that  all 
things,  plants  and  animals,  can  be  reduced  to  water,  that 
they  are  in  fact  water  endued  with  certain  properties. 

The  Chemical  System,  founded  by  Sylvius  (1614-1672), 
was  based  upon  the  elements  of  chemistry,  the  new 
knowledge  of  the  circulation  and  the  improved  anatomy. 
It  absolutely  neglected  the  vital  forces  of  life.  It  was  a 
system  of  "humors."  Altho  Van  Helmont  paid  little 
heed  to  that  part  of  physiology  which  is  derived  by  deduc- 
tions from  anatomy,  by  experiments  on  animals  or  by  the 
application  of  mechanical  principles,  Sylvius  was  well 
versed  in  all  these  things,  and  wrote  well  on  the  circula- 
tion of  the  blood  and  on  the  mechanics  of  respiration. 

The  humoral  physiology  of  Sylvius,  instead  of  the  four 
cardinal  fluids,  adopts  the  "triumvirate"  of  the  saliva,  the 


190  MEDICINE 

pancreatic  fluid  and  the  bile.  Instead  of  the  varieties  of 
the  pneuma,  it  accepts  the  collective  idea  of  the  "vital 
spirits,"  in  contradistinction  to  the  system  of  Van  Hel- 
mont,  and  from  this  time  forward  played  one  of  the  most 
prominent  parts,  and  occasioned  the  greatest  confusion,  in 
the  theoretic  views  of  medicine.  The  forces  were  com- 
pelled to  give  place  to  the  chemical  process  of  fermenta- 
tion and  effervescence,  the  qualities,  to  acid  and  alkali 
(originating  in  the  acid  or  alkaline  salt).  Saliva  and  pan- 
creatic fluid  are  acid.  The  bile  is  alkaline ;  the  first  effects 
stomach-digestion,  while  the  two  latter  accomplish  the 
digestion  of  the  chyme  into  chyle  and  feces.  In  this 
process,  an  effervescence  occurs  and  produces  a  kind  of 
gas,  which,  in  the  form  of  volatile  spirit,  with  a  delicate 
oil  and  salt  neutralized  by  a  weak  acid,  enters  into  the 
composition  of  the  chyme.  Such  a  spirit  of  fermentation 
is  also  transmitted  from  the  spleen  to  the  blood  and  per- 
fects the  latter.  Hence  the  importance  of  the  spleen  (with 
which  the  glands  are  connected  in  importance  and  action) 
becomes  perfectly  clear. 

The  blood  is  the  headquarters  for  the  development  of 
the  processes  of  healthy  and  of  morbid  life.  Normally,  it 
contains  the  bile  already  preformed.  This  is  separated 
in  the  gall-bladder,  but  again  partially  mixed  in  the  liver 
with  the  blood,  whose  fluidity  it  serves  to  maintain.  The 
blood  and  bile  then  proceed  to  the  right  side  of  the  heart, 
where  both  (together  with  the  chyle)  bring  about  a  vital 
fermentation  by  means  of  the  innate  heat  of  the  latter 
organ.  In  the  lungs  the  blood  of  the  right  heart  is  again 
cooled,  and  passes  to  the  left  side  of  the  heart,  which,  on 
its  part,  is  dilated  by  a  new  "effervescence"  of  the  blood. 

The  contraction  of  this  half  of  the  heart  is  now  excited 
by  means  of  the  vital  spirits,  and  the  blood  is  driven  into 
the  greater  circulation.  These  vital  spirits,  comparable  in 
their  nature  to  alcohol,  are  distilled  in  the  brain  (still 
regarded  as  a  glandular  organ),  and  are  carried  by  the 
nerves  (which  were  supposed  to  be  hollow)  to  the  whole 


THE  CENTURY  OF  SCHOOLS  191 

body,  in  order  to  facilitate  sensation.  The  vital  spirits 
which  reach  the  glands,  by  means  of  an  acid  developed 
from  the  blood,  undergo  here  their  metamorphosis  into 
lymph.  Under  the  form  of  lymph  they  return  once  more 
to  the  blood,  passing  from  the  glands  into  the  brain,  thus 
forming  a  circulation  distinct  from  that  of  the  blood.  The 
milk,  however,  which  is  related  to  lymph,  originates  from 
the  blood,  which,  through  the  influence  of  a  mild  acid 
prepared  in  the  mammary  gland,  changes  its  color  in  that 
organ,  just  as  vegetable  colors  are  changed  by  the  action 
of  acids. 

According  to  the  general  pathology  of  Sylvius,  health 
consists  in  the  undisturbed  performance  in  the  body  of  the 
process  of  fermentation,  without  the  appearance  of  the 
acid  or  alkaline  salt.  If,  however,  one  of  the  two  latter 
salts  becomes  prominent,  it  gives  rise  to  an  acridity  and 
furnishes  the  cause  of  diseases.  The  individual  diseases 
are  divided  into  two  groups :  those  depending  upon  an 
acid  acridity,  and  those  originating  in  an  alkaline  acridity. 
The  two  varieties  of  acridity,  however,  are  subject  to 
numerous  modifications,  and  thus  arise  subordinate  classes 
of  the  above  groups  of  diseases.  The  bile  is  an  example 
of  the  principal  humors;  if  it  is  alkaline,  it  occasions 
ardent  and  continued  fever;  if  acid,  it  is  the  cause  of 
engorgements. 

In  regard  to  the  semeiology,  diagnostics  and  therapeutic 
principles  of  Sylvius,  the  following  passage  furnishes  some 
clue:  "As  often  as  the  whole  blood  appears  black,  it 
indicates  that  acidity  predominates ;  if  the  blood  is  redder, 
it  shows  that  the  bile  in  it  is  superabundant.  In  the  first 
case,  that  acid  in  the  body  and  in  the  blood  must  be 
diminished ;  in  the  second,  the  bile  must  be  lessened  and  its 
power  broken.  If  the  blood,  which  normally  is  free  from 
odor  and  of  a  sweetish  taste (  especially  the  serum),  tastes 
salty,  the  alkali  in  the  body  is  too  pure,  and  when  brought 
into  contact  with  the  acid  spiritus,  engenders  a  humor  of  a 
saline  taste  and  prejudicial  to  the  body;  for  such  a  taste, 


192  MEDICINE 

tho  milder,  may  pass  into  the  urine,  but  not  into  the  serum 
or  its  products,  the  lymph,  the  pancreatic  juice  and  the 
saliva.  This  saline  taste  indicates  a  reduction  and  correc- 
tion of  the  alkali."  Fever  is  diagnosticated  by  the  pulse, 
not  by  the  heat  of  the  body. 

Accordingly,  therapeutics  has  two  extremely  simple 
'duties:  to  get  rid  of  the  acid  or  the  alkali.  The  first  is 
accomplished  by  the  administration  of  alkalis,  the  latter, 
by  the  prescription  of  acids.  The  "effervescence  of  the 
bile"  and  the  diseases  flowing  therefrom  are  removed  by 
cathartics.  Sylvius  recommended  diaphoretics,  absorbents 
and  emetics,  but  reprehended  bleeding.  Opium  is  of  ser- 
vice against  both  acid  and  alkali,  since  it  tempers  equally 
both  acridity  and  effervescence.  The  general  objects  of 
therapeutics  (never,  alas,  to  be  accomplished)  are  "to 
maintain  the  strength,  to  remove  diseases,  to  mitigate 
symptoms  and  to  remove  their  causes."  The  stereotyped 
theory,  and  especially  the  stereotyped  therapeutics  of 
Sylvius  gained  for  him  a  large  following;  but  they  also 
procured  him  numerous  opponents,  especially  in  later 
times,  when  his  therapeutics  were  reproached  with  having 
during  their  prevalence  cost,  on  the  whole,  as  many  human 
lives  as  the  Thirty  Years'  War.  This,  under  any  circum- 
stances, is  an  exaggerated  estimate,  for  nature,  from  the 
most  remote  ages  down  to  the  present  day,  has  preserved 
the  sick,  at  least  in  the  majority  of  cases,  from  the  worst 
consequences  of  the  healing  art  of  infatuated  theorists  and 
corrupt  or  incapable  practitioners.  But  Sylvius  must  be 
given  credit  for  having  brought  the  chemical  investigation 
of  physiological  problems  into  line  with  the  mechanical 
and  physical  investigation  of  them. 

In  opposition  to  the  Chemical  School,  Borelli  (1608- 
1679)  formed  the  Mechanical  or  Physical  School.  He 
sought  to  explain  most,  if  not  all,  the  phenomena  of  the 
living  body  as  mere  problems  of  the  new  mathematical, 
mechanical  and  physical  science.  For  instance,  he  taught 
that  digestion  is  a  purely  mechanical  process.  Concerning 


THE  CENTURY  OF  SCHOOLS  193 

gastric  digestion  itself,  Borelli,  with  his  mind  directed 
•chiefly  to  mechanical  effects,  had  pointed  out  the  great 
grinding,  crushing  force  which  was  provided  for  by  the 
muscular  coats  of  the  stomach.  He  calls  attention  to  the 
fact  "that  in  birds,  with  few  exceptions,  the  crushing, 
erosion  and  trituration  of  food  is  effected  by  the  muscular 
stomach  itself,  compressing  one  part  of  its  horny  lining 
against  another.  Thus,  with  the  help  of  small  hard  and 
sharp  pebbles  contained  in  it,  which  serve  instead  of 
teeth,  the  stomach,  by  pounding  the  food  swallowed  and 
rubbing  its  inner  surfaces  on  it  this  way  and  that,  like 
millstones,  crushed  the  parts  of  the  food  until  they  are 
converted  into  a  very  fine  powder." 

He  appears  to  think  that  in  most  birds  the  digestive 
action  is  wholly  mechanical,  and  indeed  he  maintained  that 
the  pebbles  in  the  stomach  might  be  not  only  mere  mechan- 
ical aids,  but  when  crushed  might  serve  for  nutriment. 
He  admits,  however,  in  the  case  of  some  stomachs,  there 
is  a  corrosive  juice.  In  this  point,  as  in  others,  the  fol- 
lowers of  Borelli  went  beyond  their  master,  and  the 
physical  school  after  him  were  prepared  to  deny  action  in 
all  cases,  and  to  maintain  the  digestion  was  in  reality  a 
mere  trituration  of  the  food  by  the  muscular  mill  of  the 
stomach  into  the  creamy  mass  known  as  chyle. 

In  pathology  Borelli  was  an  opponent  of  the  Chemical 
School,  on  the  ground  that  it  was  demonstrable  neither 
by  common  experience  nor  by  experiment,  and  he  denies 
as  well  any  evidence  that  fever  originates  in  excessive 
action  of  the  heart-muscle,  due  to  irritation  of  the  latter 
by  an  acrid  nervous-fluid.  There  is  no  such  thing  as 
corruption  of  the  blood,  and,  even  if  there  were,  a  stoppage 
of  the  organs  of  secretion  is  rather  to  be  assumed.  In  his 
therapeutics  Borelli  considers  purgation  and  bleeding  in- 
effective in  removing  the  acidity  of  the  nervous  fluid,  but 
he  expects  that  strengthening  the  organs  by  means  of 
cinchona  and  favoring  the  invisible  perspiration  will  be 


194  MEDICINE 

the  more  effectual  in  fever.  He  alone,  too,  remains  true 
to  the  mechanical  theory  in  therapeutics. 

There  was  one  man,  however,  in  this  century  of  un- 
scientific systems  or  schools,  who  steered  clear  of  the 
influences  of  his  day.  He  was  Thomas  Sydenham  (1624- 
1689),  an  Englishman.  His  model  was  Hippocrates,  upon 
whom  he  seems  to  have  formed  himself  almost  exclusively, 
and  whose  principles,  with  some  modifications  resulting 
from  the  condition  of  knowledge  in  his  day — on  the  whole, 
only  a  few — he  made  his  own.  In  pathology  he  was,  like 
Hippocrates,  a  humorist  without  being  a  theorist,  and  he 
defended  himself  against  those  who  laid  this  to  his 
reproach  in  almost  the  same  words  used  by  Hippocrates. 
Like  the  latter,  too  (Sydenham  was  called  the  "English 
Hippocrates"),  he  knew  only  one  standard — observation 
and  experience — tho  he  was  somewhat  skeptical  as  to  the 
certainty  of  their  results,  and,  like  him,  he  recognised 
nature,  or  the  healing  power  of  nature,  as  the  sole, 
ultimate,  undefined  and  undefinable,  but  (fortunately  for 
physicians)  existing  and  powerful  assistant. 

In  accordance  with  his  disposition  to  practical  objects, 
Sydenham  laid  little  weight  upon  anatomy  and  physiology, 
a  feeling  which  he  shared  with  almost  all  great  practition- 
ers. Yet  he  recognised  their  value  when  not  employed  in 
the  production  of  hypotheses  based  upon  pure  theory.  The 
latter  he  rejected,  tho  he  admitted  hypotheses  borrowed 
from  practice  for  the  sake  of  elucidating  disease,  and 
especially  for  the  determination  of  curative  indications, 
or  of  a  definite  therapeutics  (hypotheses  based  upon  prac- 
tice). 

While  Medicine  was  thus  struggling  through  its  systems 
and  schools,  Surgery  worked  slowly  and  surely  into  a 
scientific  branch  free  from  speculation  and  theories.  The 
tourniquet  was  invented  by  Morel,  and  the  first  trans- 
fusion of  blood  from  one  person  to  another  was  performed 
by  Denis.  Obstetrics  advanced  even  more  than  surgery, 
and  began  finally  to  pass  out  of  the  hands  of  women  into 


THE  CENTURY  OF  SCHOOLS  195 

the  care  of  men,  and  these  simple  surgeons,  not  physicians, 
contributed  not  a  little  to  its  improvement.  Scientifically 
it  was  greatly  benefited  by  anatomy  and  physiology,  but 
practically  it  did  not  make  such  marked  progress  at  first. 
The  invention  of  obstetric  forceps  was  at  first  of  no 
benefit  to  practical  obstetrics,  since  it  was  kept  secret  by 
the  Chamberlen  family,  who  invented  the  instrument. 
Seventy-five  years  after  the  occurrence  of  this  invention, 
De  la  Motte  was  driven  to  utter  the  following  sentence, 
which,  even  if  it  be  just,  is  not  particularly  merciful: 
"He  who  keeps  secret  so  beneficent  an  instrument  as  the 
harmless  obstetric  forceps,  deserves  to  have  a  worm 
devour  his  vitals  for  all  eternity,  for  all  human  science, 
up  to  the  present  time,  has  not  been  able  to  find  such  an 
instrument !" 

The  circulation  of  the  blood  was  first  correctly  and 
distinctly  set  forth  by  William  Harvey  (1578-1667).  He 
was  an  Englishman,  who  studied  first  at  Cambridge  and 
then  went  to  Padua,  where  he  worked  in  the  study  of 
medicine  for  four  years.  It  must  be  remembered  that 
Harvey  had  not  the  exact  sciences  of  physics  or  of  chem- 
istry on  which  to  base  his  experiments.  Harvey's  must  be 
ranked  the  foremost  master-mind,  for  altho  Vesalius, 
Servetus,  and  Fabricius  all  opened  new  fields  in  the 
physiology  of  the  heart  and  circulation,  it  remained  for 
Harvey  to  demonstrate  the  great  truths  which  his  prede- 
cessors had  failed  to  grasp.  Refuting  the  erroneous  ideas 
of  the  ancients,  and  with  an  eye  upon  the  teachings  of 
Aristotle,  Galen,  Colombo  and  others — the  work  of  Ser- 
vetus was  unknown  to  him,  while  Aristotle  and  Galen  were 
cautiously  opposed — but  on  all  new  points  proceeding  only 
upon  purely  experimental  methods,  Harvey  set  forth  the 
doctrine  of  the  circulation  as  it  is  held  to-day.  He  first 
presented  the  ancient  beliefs  on  the  subject  in  his  won- 
derful paper:  "As  we  are  about  to  discuss  the  motion, 
action  and  use  of  the  heart  and  arteries,"  he  says,  "it  is 
imperative  to  state  what  has  been  thought  of  these  things 


196  MEDICINE 

by  others  in  their  writings,  and  what  has  been  held  by  the 
vulgar  and  by  tradition,  in  order  that  what  is  true  may  be 
confirmed,  and  what  is  false  set  right  by  dissection,  multi- 
plied experience  and  accurate  observation. 

"Almost  all  anatomists,  physicians  and  philosophers  up 
to  the  present  time  have  supposed,  with  Galen,  that  the 
object  of  the  pulse  was  the  same  as  that  of  respiration, 
and  only  differed  in  one  particular,  this  being  conceived  to 
depend  on  the  animal,  the  respiration  on  the  vital  faculty; 
the  two,  in  all  other  respects,  whether  with  reference  to 
purpose  or  to  motion,  comporting  themselves  alike. 
Whence  it  is  affirmed,  as  by  Hieronymus  Fabricus  of 
Aquapendente,  in  his  book  on  'Respiration/  which  has 
lately  appeared,  that  as  the  pulsation  of  the  heart  and 
arteries  does  not  suffice  for  the  ventilation  and  refrigera- 
tion of  the  blood,  therefore  were  the  lungs  fashioned  to 
surround  the  heart.  From  this  it  appears  that  whatever 
has  hitherto  been  said  upon  the  systole  and  diastole,  or 
on  the  motion  of  the  heart  and  arteries,  has  been  said  with 
especial  reference  to  the  lungs. 

"But  as  the  structure  and  movements  of  the  heart  differ 
from  those  of  the  lungs,  and  the  motions  of  the  arteries 
from  those  of  the  chest,  so  it  seems  likely  that  other  ends 
and  offices  will  thence  arise,  and  that  the  pulsations  and 
uses  of  the  heart,  likewise  of  the  arteries,  will  differ  in 
many  respects  from  the  heavings  and  uses  of  the  chest 
and  lungs.  For  did  the  arterial  pulse  and  the  respiration 
serve  the  same  ends;  did  the  arteries  in  their  diastole 
take  air  into  their  cavities,  as  is  commonly  stated,  and  in 
their  systole  emit  fuliginous  vapors  by  the  same  pores  of 
the  flesh  and  skin ;  and  further,  did  they,  in  the  time  inter- 
mediate between  the  diastole  and  the  systole,  contain  air, 
and  at  all  times  either  air  or  spirits,  or  fuliginous  vapors, 
what  should  then  be  said  to  Galen,  who  wrote  a  book  on 
purpose  to  show  that  by  nature  the  arteries  contained 
blood,  and  nothing  but  blood,  and  consequently  neither 


THE  CENTURY  OF  SCHOOLS  197 

spirits  nor  air,  as  may  readily  be  gathered  from  the  experi- 
ments and  reasonings  contained  in  the  same  book? 

"Now,  if  the  arteries  are  filled  in  the  diastole  with  air 
then  taken  into  them  (a  larger  quantity  of  air  penetrating 
when  the  pulse  is  large  and  full),  it  must  come  to  pass 
that  if  you  plunge  into  a  bath  of  water  or  of  oil  when  the 
pulse  is  strong  and  full,  it  ought  forthwith  to  become  either 
smaller  or  much  slower,  since  the  circumambient  bath 
will  render  it  either  difficult  or  impossible  for  the  air  to 
penetrate.  In  like  manner,  as  all  the  arteries,  those  that 
are  deep-sealed  as  well  as  those  that  are  superficial,  are 
dilated  at  the  same  instant  and  with  the  same  rapidity, 
how  is  it  possible  that  air  should  penetrate  to  the  deeper 
parts  as  freely  and  quickly  through  the  skin,  flesh  and 
other  structures,  as  through  the  cuticle  alone?  And  how 
should  the  arteries  of  the  fetus  draw  air  into  their  cavities 
through  the  abdomen  of  the  mother  and  the  body  of  the 
womb? 

"And  how  should  seals,  whales,  dolphins,  and  other 
cetaceans,  and  fishes  of  every  description,  living  in  the 
depths  of  the  sea,  take  in  and  emit  air  by  the  diastole  and 
systole  of  their  arteries  through  the  infinite  mass  of  water? 
For  to  say  that  they  absorb  the  air  that  is  present  in  the 
water,  and  emit  their  fumes  into  this  medium,  were  to 
utter  something  like  a  figment.  And  if  the  arteries  in 
their  systole  expel  fuliginous  vapors  from  their  cavities 
through  the  pores  of  the  flesh  and  skin,  why  not  the 
spirits,  which  are  said  to  be  contained  in  those  vessels, 
at  the  same  time,  since  spirits  are  much  more  subtile  than 
fuliginous  vapors  or  smoke? 

"And  if  the  arteries  take  in  and  cast  out  air  in  the 
systole  and  diastole,  like  the  lungs  in  the  process  of 
respiration,  why  do  they  not  do  the  same  thing  when  a 
wound  is  made  in  one  of  them,  as  in  the  operation  of 
arteriotomy?  When  the  windpipe  is  divided,  it  is  suf- 
ficiently obvious  that  the  air  enters  and  returns  through 
the  wound  by  two  opposite  movements;  but  when  an 


198  MEDICINE 

artery  is  divided,  it  is  equally  manifest  that  blood  escapes 
in  one  continuous  stream,  and  that  no  air  either  enters 
or  issues.  If  the  pulsations  of  the  arteries  fan  and  refrig- 
erate the  several  parts  of  the  body,  as  the  lungs  do  the 
heart,  how  comes  it,  as  is  commonly  said,  that  the  arteries 
carry  the  vital  blood  into  the  different  parts,  abundantly 
charged  with  vital  spirits,  which  cherish  the  heat  of  these 
parts,  sustain  them  when  asleep,  and  recruit  them  when 
exhausted  ? 

"How  should  it  happen  that,  if  you  tie  the  arteries,  im- 
mediately the  parts  not  only  become  torpid  and  frigid, 
and  look  pale,  but  at  length  cease  even  to  be  nourished? 
This,  according  to  Galen,  is  because  they  are  deprived  of 
the  heat  which  flowed  through  all  parts  from  the  heart, 
as  its  source;  whence  it  would  appear  that  the  arteries 
rather  carry  warmth  to  the  parts  than  serve  for  any  fan- 
ning or  refrigeration.  Besides,  how  can  their  diastole 
draw  spirits  from  the  heart  to  warm  the  body  and  its 
parts,  and  means  of  cooling  them  from  without?  Still 
further,  altho  some  affirm  that  the  lungs,  arteries  and  heart 
have  all  the  same  offices,  they  yet  maintain  that  the  heart 
is  the  workshop  of  the  spirits,  and  that  the  arteries  con- 
tain and  transmit  them ;  denying,  however,  in  opposition 
to  the  opinion  of  Columbus,  that  the  lungs  can  either  make 
or  contain  spirits.  They  then  assert,  with  Galen,  against 
Erasistratus,  that  it  is  the  blood,  not  spirits,  which  is  con- 
tained in  the  arteries. 

"Nor  let  any  one  imagine  that  the  uses  of  the  pulse  and 
the  respiration  are  the  same,  because,  under  the  influences 
of  the  same  causes,  such  as  running,  anger,  the  warm 
bath,  or  any  other  heating  thing,  as  Galen  says,  they 
become  more  frequent  and  forcible  together.  For  not  only 
is  experience  in  opposition  to  this  idea,  tho  Galen  en- 
deavors to  explain  it  away,  when  we  see  that  with  exces- 
sive repletion  the  pulse  beats  more  forcibly,  while  the 
respiration  is  diminished  in  amount;  but  in  young  persons 
the  pulse  is  quick,  while  respiration  is  slow.  So  it  is  also 


THE  CENTURY  OF  SCHOOLS  199 

in  alarm  and  amid  care,  and  under  anxiety  of  mind; 
sometimes,  too,  in  fevers,  the  pulse  is  rapid,  but  the 
respiration  is  slower  than  usual. 

"These  and  other  objections  of  the  same  kind  may 
be  urged  against  the  opinions  mentioned.  Nor  are  the 
views  that  are  entertained  of  the  offices  and  pulse  of  the 
heart,  perhaps,  less  bound  up  with  great  and  most  inex- 
tricable difficulties.  The  heart,  it  is  vulgarly  said,  is  the 
fountain  and  workshop  of  the  vital  spirits,  the  center 
from  which  life  is  dispensed  to  the  several  parts  of  the 
body.  Yet  it  is  denied  that  the  right  ventricle  makes 
spirits,  which  is  rather  held  to  supply  nourishment  to  the 
lungs.  For  these  reasons  it  is  maintained  that  fishes  are 
without  any  right  ventricle  (and  indeed  every  animal 
wants  a  right  ventricle  which  is  unfurnished  with  lungs), 
and  that  the  right  ventricle  is  present  solely  for  the  sake 
of  the  lungs. 

"Moreover,  when  they  appoint  the  pulmonary  artery,  a 
vessel  of  great  size,  with  the  coverings  of  an  artery,  to 
none  but  a  kind  of  private  and  single  purpose  (that,  name- 
ly, of  nourishing  the  lungs),  why  should  the  pulmonary 
vein,  which  is  scarcely  so  large,  which  has  the  coats  of  a 
vein,  and  is  soft  and  lax,  be  presumed  to  be  made  for  many 
— three  or  four  different — uses  ?  For  they  will  have  it  that 
air  passes  through  this  vessel  from  the  lungs  into  the  left 
ventricle ;  that  fuliginous  vapors  escape  by  it  from  the 
heart  into  the  lungs;  and  that  a  portion  of  the  spirituous 
blood  is  distributed  to  the  lungs  for  their  refreshment. 

"If  they  will  have  it  that  fumes  and  air — fumes  flowing 
from,  air  proceeding  toward,  the  heart — are  transmitted  by 
the  same  conduit,  I  reply,  that  nature  is  not  wont  to  con- 
struct but  one  vessel,  to  contrive  but  one  way  for  such 
contrary  motions  and  purposes,  nor  is  anything  of  the 
kind  seen  elsewhere. 

"Since,  therefore,  from  the  foregoing  considerations  and 
many  others,  to  the  same  effect,  it  is  plain  that  what  has 
heretofore  been  said  concerning  the  motion  and  function 


200 


MEDICINE 


of  the  heart  and  arteries  must  appear  obscure,  inconsistent, 
or  even  impossible  to  him  who  carefully  considers  the 
subject,  it  will  be  proper  to  look  more  narrowly  into  the 


Lg,  lung. 


A1,  arteries  to  the 
upper  part  of  the 
body. 

PV,  pulmonary 
vein. 

LA,  left  auricle. 

Ao,  aorta. 

JLV,  left  ventricle. 


Ly,  lymphatics. 


V1,  veins  of  the  upi 

per  part  of  thq 

body. 
VCS,  superior  vena. 

cava. 
Th.D,  thoracic 

duct. 
RA,  right  auricle. 

PA,  pulmonary  ar» 

tery. 
VCI,  inferior  ven^ 

cava. 
RV,  right  ventricle, 

Let,  lacteals. 

Al,    alimentary   ca-i 

nal. 
Lr,  liver. 


HV,  hepatic  vein. 
VP,  portal  vein. 


A2,  arteries  to  the 
lower  part  of  the 
body. 

HA,  hepatic  artery, 
which  supplies 
the  liver  with 
part  of  its  blood. 


Fig.  8 — COURSE  OF  CIRCULATION  OF  BLOOD  VIEWED  FROM  BEHIND 

The  arrows  indicate  the  course  of  the  blood,  lymph,  and  chyle. 
The  vessels  which  contain  arterial  blood  have  dark  contours, 
while  those  which  carry  venous  blood  have  light  contours. 

matter  to  contemplate  the  motion  of  the  heart  and  arteries, 
not  only  in  man,  but  in  all  animals  that  have  hearts;  and 


THE  CENTURY  OF  SCHOOLS  2or 

also,  by  frequent  appeals  to  vivisection,  and  much  ocular 
inspection,  to  investigate  and  discern  the  truth." 

Harvey  divided  the  circulation  into  three  sections:  the 
lesser,  the  greater  and  that  of  the  heart  itself.  In  his 
prolonged  investigations  he  made  use  of  both  warm  and 
cold  blooded  animals,  but  differed  from  our  "exact"  inves- 
tigators of  the  present  day  in  not  describing  minutely  each 
individual  experiment,  but  contenting  himself  with  ad- 
ducing his  results  and  leaving  to  deduction  its  just  place. 
He  computed  the  mass  of  the  blood,  and  thus  proved  that 
there  must  be  a  circulation,  for  all  the  blood  could  not  be 
employed  in  nutrition,  nor  could  it  all  be  newly  supplied 
by  the  absorption  of  nutriment.  Of  "spiritus"  he  said 
that  he  had  never  found  anything  of  the  kind  in  his  dissec- 
tions. He  still  lacked,  however,  the  intermediate  bond  of 
the  capillary  zone.  In  place  of  this  he  assumed  larger 
porosities  of  the  flesh  and  vessels,  tho  he  also  employed  the 
term  "capillaries."  He  still  regards  the  heart  as  the  place 
for  the  improvement  of  the  blood  and  the  renewal  of  its. 
strength,  and  calls  it  "the  sun  of  the  microcosm,  the 
beginning  of  life,  the  household-god  of  the  body,  the 
author  of  everything,  the  foundation  of  life." 

He  goes  on  to  describe  his  experiments  on  animals  and 
to  prove  his  assertions.  "In  the  first  place,  then,  when  the 
chest  of  a  living  animal  is  laid  open  and  the  capsule  that 
immediately  surrounds  the  heart  is  slit  up  or  removed,  the 
organ  is  seen  now  to  move,  now  to  be  at  rest;  there  is  a 
time  when  it  moves,  and  a  time  when  it  is  motionless. 
These  things  are  more  obvious  in  the  colder  animals,  such 
as  toads,  frogs,  serpents,  small  fishes,  crabs,  shrimps, 
snails  and  shell-fish.  They  also  become  more  distinct  in 
warm-blooded  animals,  such  as  the  dog  and  hog,  if  they 
be  attentively  noted  when  the  heart  begins  to  flag,  to 
move  more  slowly,  and,  as  it  were,  to  die;  the  movements 
then  become  slower  and  rarer,  the  pauses  longer,  by  which 
it  is  made  much  more  easy  to  perceive  and  unravel  what 
the  motions  really  are,  and  how  they  are  performed.  In 


202  MEDICINE 

the  pause,  as  in  death,  the  heart  is  soft,  flaccid,  exhausted, 
lying,  as  it  were,  at  rest. 

"In  the  motion,  and  interval  in  which  this  is  accom- 
plished, three  principal  circumstances  are  to  be  noted: 
I.  That  the  heart  is  erected,  and  rises  upward  to  a  point, 
so  that  at  this  time  it  strikes  against  the  breast  and  the 
pulse  is  felt  externally.  2.  That  it  is  everywhere  con- 
tracted, but  more  especially  toward  the  sides,  so  that  it 
looks  narrower,  relatively  longer,  more  drawn  together. 
The  heart  of  an  eel,  taken  out  of  the  body  of  the  animal 
and  placed  upon  the  table  or  the  hand,  shows  these  par- 
ticulars; but  the  same  things  are  manifest  in  the  hearts 
of  all  small  fishes  and  of  those  colder  animals  where  the 
organ  is  more  conical  or  elongated.  3.  The  heart  being 
grasped  in  the  hand,  is  felt  to  become  harder  during  its 
action.  Now,  this  hardness  proceeds  from  tensions,  pre- 
cisely as  when  the  forearm  is  grasped,  its  tendons  are 
perceived  to  become  tense  and  resilient  when  the  fingers 
are  moved.  4.  It  may  further  be  observed  in  fishes  and 
the  colder-blooded  animals,  such  as  frogs,  serpents,  etc., 
that  the  heart,  when  it  moves,  becomes  of  a  paler  color, 
when  quiescent  of  a  deeper  blood-red  color. 

"From  these  particulars  it  appears  evident  to  me  that 
the  motion  of  the  heart  consists  in  a  certain  universal 
tension — both  contraction  in  the  line  of  its  fibers  and  con- 
striction in  every  sense.  It  becomes  erect,  hard,  and  of 
diminished  size  during  its  action;  the  motion  is  plainly 
of  the  same  nature  as  that  of  the  muscles  when  they  con- 
tract in  the  line  of  their  sinews  and  fibers ;  for  the  muscles, 
when  in  action,  acquire  vigor  and  tenseness,  and  from  soft 
become  hard,  prominent,  and  thickened;  and  in  the  same 
manner  the  heart. 

"We  are  therefore  authorized  to  conclude  that  the  heart, 
at  the  moment  of  its  action,  is  at  once  constricted  on  all 
sides,  rendered  thicker  in  its  parietes  and  smaller  in  its 
ventricles,  and  so  made  apt  to  project  or  expel  its  charge 
of  blood.  This,  indeed,  is  made  sufficiently  manifest  by 


THE  CENTURY  OF  SCHOOLS  203 

the  preceding  fourth  observation,  in  which  we  have  seen 
that  the  heart,  by  squeezing  out  the  blood  that  it  con- 
tains, becomes  paler,  and  then  when  it  sinks  into  repose 
and  the  ventricle  is  filled  anew  with  blood,  that  the  deeper 
crimson  color  returns.  But  no  one  need  remain  in  doubt 
of  the  fact,  for  if  the  ventricle  be  pierced  the  bloo'd  will 
be  seen  to  be  forcibly  projected  outward  upon  each  motion 
or  pulsation  when  the  heart  is  tense. 

"These  things,  therefore,  happen  together  or  at  the 
same  instant:  the  tension  of  the  heart,  the  pulse  of  its 
apex,  which  is  felt  externally  by  its  striking  against  the 
chest,  the  thickening  of  its  parietes,  and  the  forcible) 
expulsion  of  the  blood  it  contains  by  the  constriction  of 
its  ventricles. 

"And  now  I  may  be  allowed  to  give  in  brief  my  view  of 
the  circulation  of  the  blood,  and  to  propose  it  for  general 
adoption.  Since  all  things,  both  argument  and  ocular 
demonstration,  show  that  the  blood  passes  through  the 
lungs  and  heart  by  the  force  of  the  ventricles,  and  is  sent 
for  distribution  to  all  parts  of  the  body,  where  it  makes 
its  way  into  the  veins  and  porosities  of  the  flesh,  and  then 
flows  by  the  veins  from  the  circumference  on  every  side  to 
the  center,  from  the  lesser  to  the  greater  veins,  and  is  by 
them  finally  discharged  into  the  vena  cava  and  right 
auricle  of  the  heart,  and  this  in  such  a  quantity  or  in  such 
a  flux  and  reflux  thither  by  the  arteries,  hither  by  the 
veins,  as  cannot  possibly  be  supplied  by  the  ingesta,  and 
is  much  greater  than  can  be  required  for  mere  purposes  of 
nutrition,  it  is  absolutely  necessary  to  conclude  that  the 
blood  in  the  animal  body  is  impelled  in  a  circle,  and  is  in  a 
state  of  ceaseless  motion ;  that  this  is  the  act  or  function 
which  the  heart  performs  by  means  of  its  pulse ;  and  that 
it  is  the  sole  and  only  end  of  the  motion  and  contraction 
of  the  heart. 

"But  the  following  matter  seems  worthy  of  consider- 
ation, the  reason,  namely,  why  veins  when  ligatured  swell 
on  the  far  side  and  not  on  the  near  side  of  the  ligature. 


204  MEDICINE 

This  is  a  fact  well  known  by  experience  to  those  who  let 
blood;  for  they  place  the  ligature  on  the  near  side  of  the 
place  of  incision,  not  on  the  far  side,  because  the  veins 
swell  on  the  far  side,  not  on  the  near  side  of  the  ligature. 
But  exactly  the  contrary  ought  to  happen  if  the  movement 
of  the  blood  and  the  spirits  took  place  in  the  direction 
from  the  viscera  to  all  parts  of  the  body.  When  a  channel 
is  interrupted,  the  flow  beyond  the  interruption  ceases ;  the 
swelling  of  the  veins  therefore  ought  to  be  on  the  near 
side  of  the  ligature." 

Harvey  erred  in  subordinate  points — e.g.,  in  respect  to 
the  quantity  of  blood  driven  into  the  arteries  at  each 
systole  of  the  heart,  which  he  assumed  to  be  half  an 
ounce — but  even  if  his  anatomical  description  of  the  struc- 
ture of  the  heart  was  insufficient  and,  indeed,  imperfect, 
he  was  certainly  the  first  who  introduced  the  heart  into 
its  right  place  in  the  circulation  in  accordance  with  its 
mechanical  significance  and  action — an  advance  which 
cannot  be  disputed  or  denied  him.  The  main  facts  of  his 
exposition  remained  quite  indisputable,  altho  in  his  own 
day  they  were  heavily  assailed,  and  these  accessory  mat- 
ters were  eagerly  utilized  as  a  means  of  attack.  The 
previous  doctrine  of  the  importance  of  the  liver,  and  of 
the  "spirits"  in  the  heart,  was  first  overthrown  by  him, 
and  with  it  fell  the  four  immemorial  fundamental  humors 
and  qualities. 

That  so  important  a  discovery,  which  cleared  up  the 
ancient  and  time-honored  obscurities  and  overturned  the 
whole  physiological  and  philosophical  foundations  of  the 
medicine  of  the  past,  by  certain  results  gained  through  the 
inductive  method,  necessarily  created  among  medical  men 
both  opponents  and  partizans  in  great  number,  is  self- 
evident.  It  is  a  fashion  to  speak  of  Harvey  as  'the  im- 
mortal discoverer  of  the  circulation* ;  but  the  real  character 
of  his  work  is  put  in  a  truer  light  when  it  is  said  he 
was  the  first  to  demonstrate  the  circulation  of  the  blood. 

His  demonstration  was  the  death-blow  to  the  doctrine 


THE  CENTURY  OF  SCHOOLS  205 

of  the  'spirits/  The  names,  it  is  true,  survived  for  long 
afterward,  but  the  names  were  henceforward  devoid  of 
any  really  essential  meaning.  For  the  view  of  the  natural 
and  vital  spirits  was  based  on  the  supposed  double  supply 
of  blood  to  all  the  tissues  of  the  body,  the  supply  by  the 
veins  carrying  natural  spirits  and  the  supply  by  the 
arteries  carrying  vital  spirits.  The  essential  feature  of 
Harvey's  new  view  was  that  the  blood  through  the  body, 
passing  from  arteries  to  veins  in  the  tissues,  and  from 
veins  to  arteries  through  the  lungs  and  heart,  suffering 
changes  in  the  substance  and  pores  of  the  tissues,  changes 
in  the  substances  and  pores  of  the  lungs. 

The  new  theory  of  the  circulation  made  for  the  first 
time  possible  true  conceptions  of  the  nutrition  of  the  body, 
it  cleared  the  way  for  the  chemical  appreciation  of  the 
uses  of  blood,  it  afforded  a  basis  which  had  not  existed 
before  for  an  understanding  of  how  the  life  of  any  part,  its 
continued  existence  and  its  power  to  do  what  it  has  to 
do  in  the  body,  is  carried  on  by  the  help  of  the  blood.  And 
in  this,  perhaps,  more  than  its  being  a  true  explanation 
of  the  special  problem  of  the  heart  and  the  blood-vessels, 
lies  its  vast  importance. 

The  anatomists  of  the  sixteenth  century,  and  of  the 
early  part  of  the  seventeenth  century,  were  content,  like 
their  forefathers,  to  carry  on  their  studies  with  the  naked 
eye,  unassisted  by  any  optical  instruments.  Hence  their 
statements  as  to  the  finer  structure  of  the  various  organs 
and  parts  of  the  body  were  necessarily  vague  and  incom- 
plete. They  could  tease  certain  parts  more  or  less  com- 
pletely into  strands  of  greater  or  less  thickness,  and  hence 
could  speak  of  fibers  and  of  fibrous  structure.  They 
recognised  skins  and  membranes  of  various  thickness. 
They  could  distinguish  what  is  now  called  fatty  or  adipose 
tissue  by  means  of  its  gross  features.  And  they  could 
follow  out  the  blood-vessels  and  later  on  the  lymphatic 
vessels  until  these  were  lost  to  view  as  minute  channels. 
Beyond  this,  they  were  content  to  speak  of  that  part 


2o6  MEDICINE 

of  the  substance  of  an  organ  which  could  not  be  split  into 
fibers,  and  into  which  the  minute  vessels  seemed  to  disap- 
pear, as  'parenchyma/  using  the  word  introduced  in 
ancient  times  by  Erasistratus,  but  no  longer  attaching  to 
the  word  the  original  meaning  of  something  poured  out 
from  the  veins.  By  parenchyma  they  simply  meant  the 
parts  which  were  not  distinctly  made  up  of  fibers  and 
which  in  most  cases  at  least  were  porous.  Thus  Harvey 
speaks  of  the  blood  which  flows  along  the  pulmonary 
artery  as  being  discharged  into  the  porous  parenchyma  of 
the  lungs  and  gathered  up  thence  by  the  beginnings  of  the 
pulmonary  veins.  The  histology,  if  the  word  may  be  so 
used,  of  these  older  writers  was  of  a  simple  kind. 

It  was  only  a  short  while  later  that  Marcello  Malpighi 
(1628-1694),  a  professor  in  Bologna  University,  discov- 
ered what  Harvey  had  failed  to  explain — namely,  the 
transition  of  blood  from  arteries  to  veins  by  means  of 
the  capillary  system.  He  was  the  first  who,  calling  into 
his  aid  the  newly  invented  microscope,  opened  up  the  way 
for  a  true  grasp  of  the  minute  structure  of  the  tissues  and 
organs  of  the  animal  body,  and  in  so  doing  opened  up  also 
a  new  branch  of  physiology.  He  was  the  first  Histologist, 
and  with  the  new  histology  came  new  ideas  of  the  func- 
tions of  many  important  parts  of  the  body. 

The  microscope  revealed  to  Malpighi  features  of  struc- 
ture transcending  mere  mechanical  notions.  He  saw  that 
the  tissues  in  their  minuter  structure  were  governed  by 
laws  of  their  own,  by  laws  different  from  those  which 
determined  the  uses  of  machines ;  and  thus  there  came  to 
him  the  new  conception  of  an  animal  morphology.  In  his 
brief  epistles,  Malpighi  announced  two  discoveries  of 
fundamental  importance.  In  the  first  letter  he  described 
the  vesicular  nature  of  the  lung  and  showed  how  the 
divisions  of  the  windpipe  ended  in  the  dilated  air  vesicles. 
He  thus  for  the  first  time  supplied  an  anatomical  basis  for 
the  true  conception  of  the  respiratory  process. 

A  little  later  he  turned  his  attention  to  the  simpler  lung 


THE  CENTURY  OF  SCHOOLS 


207 


of  the  frog,  and  in  this  he  had  the  happiness,  calling  into 
his  aid  the  microscope,   to  see  that  minute  but  definite 


Fig-  9 — BLOOD-CORPUSCLES.     FIRST  DESCRIBED  BY  LEEUWENHOEK 

A,  Moderately  magnified.  The  red  corpuscles  are  seen  lying  in 
rouleaux ;  at  a  and  a  are  seen  two  white  corpuscles.  B,  Red 
corpuscles  much  more  highly  magnified,  seen  in  face ;  C,  ditto, 
seen  in  profile ;  D,  ditto,  in  rouleaux,  rather  more  highly  mag- 
nified ;  E,  a  red  corpuscle ;  F,  a  white  corpuscle  magnified  the 
same  as  B  ;  H,  red  corpuscles  puckered  or  crenate  all  over; 
I,  red  corpuscles  puckered  at  the  edge  only. 

channels,   the  channels  which  we    now    call    capillaries, 
joined  the  endings  of  the  minute  arteries  to  the  beginnings 


208  MEDICINE 

of  the  minute  veins.  This  was  the  first  observation  of  the 
capillaries.  It  made  Harvey's  work  complete. 

In  another  letter  he  says:  "And  I  myself,  in  the 
omentum  of  the  hedgehog,  in  a  blood-vessel  which  ran 
from  one  collection  of  fat  to  another  opposite  to  it,  saw 
globules  of  fat,  of  a  definite  outline,  reddish  in  color.  They 
presented  a  likeness  to  a  chaplet  of  red  coral."  He  mistook, 
however,  the  nature  of  what  he  saw.  What  evidently  were 
blood  corpuscles  he  thought  to  be  fat  cells  passing  from 
the  fatty  tissue  into  the  current  of  the  blood. 

After  this,  the  first  real  accurate  description  of  the  red 
corpuscles  is  ascribed  to  Leeuwenhoek,  who  in  1674,  in  the 
Philosophical  Transactions,  gave  an  account  of  the  red 
blood  corpuscles  in  man,  and  in  various  papers  carefully 
described  the  blood  corpuscles  of  different  animals,  show- 
ing that  while  circular  in  mammals,  they  are  oval  in  birds, 
frogs  and  fishes,  and  proving  that  in  all  cases  the  redness 
of  blood  is  due  to  these  red  bodies. 

Malpighi  was  no  mere  professor.  His  time  was  not 
spent  wholly  in  the  laboratory  and  lecture  room.  He  was 
actively  engaged  in  healing  the  sick;  he  was  as  familiar 
with  the  phenomena  of  disease  as  with  the  phenomena  of 
the  healthy  living  being.  He  brought  to  bear  on  the 
former  the  same  clear  intellect  which  he  turned  toward  the 
latter,  seeking  to  find  out  the  causes  of  the  events  which 
he  witnessed.  He  was  as  busy  in  the  post-mortem  room 
as  in  the  dissecting  theater,  and  his  writings  on  the  char- 
acter and  causes  of  disease  justify  the  claiming  for  him 
the  merit  of  having  laid  the  foundation  of  scientific 
pathology. 

Malpighi  may  also  be  regarded  as,  almost  in  the  same 
degree,  the  founder  of  that  great  and  important  branch  of 
biological  science  which  is  known  as  embryology. 

Within  a  few  years  of  the  publication  of  Harvey's 
book  anatomists  became  aware  of  a  new  set  of  vessels,* 
of  whose  existence  no  one  before  had  dreamed,  vessels 
neither  arteries  nor  veins ;  vessels  containing  not  blood,  but 


THE  CENTURY  OF  SCHOOLS  209 

either  a  milky  or  a  clear  limpid  fluid,  and  carrying  their 
contents  not  to  but  away  from  the  tissues,  carrying  them, 
moreover,  not  to  that  great  organ,  the  liver,  which  in  the 
old  view  was  the  chief  seat  of  all  concoction,  but  directly 
into  the  venous  blood  stream  and  so  to  the  heart,  from 
thence  to  be  distributed  all  over  the  body.  That  such  a 
conception  almost  at  once  found  general  acceptance  is,  as 
we  have  just  said,  a  striking  proof  of  how  rapidly  and 
profoundly  Harvey's  work  had  influenced  the  views  of 
physiologists.  These  were  the  vessels  of  the  lymphatic 
system. 

Aselli  detected  the  presence  of  valves  in  these  vessels 
and  recognised  that  they  hindered  the  backward  flow.  He 
saw  clearly,  indeed,  that  his  newly  discovered  vessels  were 
channels  for  conveying  the  chyle,  the  elaborated  contents 
of  the  intestine,  away  from  the  intestine;  but  influenced, 
doubtless,  by  the  accepted  view  that  all  the  absorbed  food 
must  be  carried  to  the  liver,  to  be  there  elaborated  into 
blood,  he  went  wrong  as  to  the  ultimate  course  taken  by 
these  vessels;  he  thought  he  could  trace  them  into  the 
liver.  It  may  here  be  noted  in  passing  that  Aselli  in  his 
treatise  speaks  of  and  indeed  figures  the  cluster  of 
lymphatic  glands  lying  in  the  mesentery  as  'the  pancreas'; 
and  this  cluster  of  glands  was  afterward  often  spoken  of 
as  'the  pancreas  of  Aselli/ 

State  medicine,  altho  much  advanced  in  the  sixteenth 
century,  was  even  more  in  the  seventeenth,  by  the  physi- 
cians of  all  civilized  countries.  Medical  police  were 
organized  for  public  hygiene,  giving  out  plague  ordinances, 
advice  relative  to  clothing  and  food,  inspection  of  provis- 
ions, etc.  The  epidemic  diseases  of  this  period  were  many 
and  very  destructive  to  human  life.  Plague  was,  perhaps, 
the  worst,  altho  typhus  fever  raged  fiercely,  especially 
during  the  Thirty  Years'  War.  Malarial  disease,  dysen- 
tery, ergotism,  scarlet  fever  and  smallpox  were  others 
which  carried  off  many  people. 

The  clerical  element  having  entirely  disappeared  from 


210  MEDICINE 

the  ranks  of  the  public  physicians,  there  was  more  oppor- 
tunity for  improvement  in  the  standing  of  the  lay  pro- 
fession. A  special  characteristic  of  the  seventeenth  cen- 
tury physician,  in  addition  to  their  great  zeal  for  science, 
is  found  in  their  frequent  and  intimate  occupation  with 
chemistry,  mathematics  and  natural  philosophy. 

One  of  the  old  state  books  of  that  century  enumerates 
the  following  practitioners  of  medicine:  I.  The  Medical 
Profession  proper :  a.  Medici  in  general :  commissioned 
court,  field,  hospital  and  plague  medici.  b.  Surgeons,  bar- 
bers, regimental  surgeons,  oculists,  herniotomists,  lith- 
otomists,  bath-keepers,  c.  Superior  sworn  midwives, 
nurses,  d.  Apothecaries,  druggists,  confectioners  and 
grocers. 

II.  Sundry  Impostors  and  Pretended  Physicians:  Old 
women,  village  priests,  hermits,  quacks,  executioners,  calf- 
doctors,  Jews,  vagrants,  musicians,  rat-catchers,  jugglers 
and  gipsies. 

Instruction  in  medicine  assumed  better  conditions.  Italy, 
which  had  for  so  long  held  first  place  in  educational  mat- 
ters, lost  hold,  the  lead  being  taken  by  France  and  the 
Netherlands.  Clinical  and  bedside  instruction  were  taken 
up  and  tried,  but  not  with  much  success.  Students  still 
had  some  influence  in  the  management  of  their  curriculi, 
but  not  to  the  same  extent  of  the  preceding  century. 
Anatomy  was  studied  more  frequently  upon  human  bodies, 
so  that  dissections  were  performed  in  most  universities. 
Occupation  with  practical  anatomy  was,  of  course,  still 
regarded  by  the  higher  physicians  as  a  business  unworthy 
of  them.  They  left  it  to  the  inferior  surgeons,  and  merely 
pointed  out  and  explained  themselves  with  a  staff  what 
the  surgeon  had  exposed.  Thus  the  surgeons  were  the 
best  anatomists  and  teachers  of  anatomy. 


CHAPTER  VII 

THE  PERIOD  OF  SYSTEMATIZATION 

IT  has  been  said  that  the  eighteenth  century  was  a 
continuation  of  the  idealistic  tendency  of  the  sixteenth, 
interrupted  by  the  seventeenth,  which  was  not  idealistic. 
The  masses  were  released  from  most  of  their  bonds  and 
fetters,  and  the  principles  of  independence  and  free  right 
of  development  were  established.  The  tendency  was 
humanitarian  rather  than  humanistic,  revolutionary  rather 
than  reformative.  The  numerous  wars  had  no  great  effect 
on  the  development  of  general  medicine,  except  surgery. 
It  is  in  Germany,  France  and  England  that  works  of  real 
permanence  are  found,  the  revival  of  experimental  physi- 
ology, development  of  physical  diagnosis  and  scientific 
study  of  statistics. 

In  the  eighteenth  century  is  found  an  age  of  systems 
and  theories,  the  outgrowth  of  the  vast  amount  of  new 
material  gathered  from  the  new  sciences.  These  systems 
lived  a  short  life,  and  in  that  brief  span  contributed  some- 
what to  the  advancement  of  medical  science.  No  system, 
even  if  it  be  wrong,  can  retard  the  progress  of  medicine, 
unless,  like  the  Galenic,  it  be  prolonged  over  a  great  space 
of  time.  The  saving  grace  of  the  systems  of  the  eighteenth 
century  lies  in  the  fact  that  they  did  not  degenerate  into 
pure  theory,  but  the  art  of  observation  was  cultivated  in  a 
prominent  manner,  and  was  practiced  carefully  and 
soberly,  aided  by  reason  and  the  use  of  the  natural  senses. 

The  Eclectic  System  was  founded  by  Boerhaave  (1668- 


212  MEDICINE 

T738),  who  was  one  of  the  greatest  of  modern  scientists. 
He  was  a  capable  chemist,  and  so  popular  a  lecturer  in 
medical  subjects  that  hearers  came  from  all  over  the 
world.  He  was  a  splendid  clinical  instructor,  and  as  a 
practitioner  is  considered  by  Baas  the  most  famous  man 
of  his  age.  He  was  the  first  to  give  separate  lectures  on 
ophthalmology  and  to  use  the  magnifying  glass  in  exam- 
ining the  eye.  His  was  a  great  character,  free  from 
vanity  and  selfishness. 

The  doctrines  of  Boerhaave  do  not  form  any  really 
new  system,  but  rather  include  many  ideas  of  the  earlier 
systems.  According  to  Boerhaave,  disease  is  that  condi- 
tion in  which  the  bodily  "actions"  are  disturbed  or  un- 
settled, and  take  place  only  with  difficulty.  The  reverse  of 
this  condition  furnishes  his  conception  in  health.  Fever  is 
the  effort  of  nature  to  ward  off  death.  Hence  the  nervous 
fluid  flows  too  quickly  into  the  muscles,  and  the  heart  con- 
tracts too  rapidly,  so  that  the  blood  flows  too  rapidly  in  the 
capillaries. 

Digestion,  like  the  circulation,  is  explained  on  mechani- 
cal principles.  He  says:  'The  antecedent  causes  of  this 
acid  acridity  are:  i.  Food  consisting  of  farinaceous,  acid 
and  juicy,  fresh,  raw,  fermenting  or  fermented  portions  of 
vegetables.  2.  The  want  of  good  blood  in  the  body  which 
receives  this  nutriment.  3.  Debility  of  the  fibrous  tissue, 
the  vessels  and  intestines.  4.  Lack  of  animal  motion. 

"Primarily,  it  has  its  seat  chiefly  in  the  localities  of 
primary  digestion,  whence  it  slowly  infects  the  blood  and 
finally  all  the  humors.  It  occasions  acid  eructations,  hun- 
ger, pain  in  the  stomach  and  bowels,  flatulence,  spasms, 
sluggishness  of  and  various  changes  in  the  bile,  and  acid 
chyle.  In  the  blood,  it  produces  pallor,  acid,  chyle,  and 
hence  in  women  milk  too  prone  to  acidity,  sour  perspira- 
tion, acid  saliva,  and  thus  itching  obstructions,  pustules, 
ulcers;  then  excitement  of  the  brain  and  nerves  with  re- 
sulting convulsions,  disturbance  of  the  circulation,  and 
finally  death.  Hence  its  effects  may  be  perfectly  predicted 


THE  PERIOD  OF  SYSTEMATIZATION      213 

and  the  mode  of  cure  may  be  known.  The  cure  is 
effected:  I.  By  animal  and  vegetable  food  opposed  to 
acidity.  2.  By  the  fluids  of  birds  of  prey,  which  fluids 
resemble  good  blood.  3.  By  strengthening  remedies.  4. 
By  active  movement.  5.  By  medicines  which  absorb, 
dilute,  weaken  or  change  the  acid.  The  selection,  prepara- 
tion, dose  and  timely  employment  of  these  remedies  depend 
upon  the  judgment  of  the  physician  as  to  the  disease,  its 
seat,  the  condition  of  the  patient,  etc.  Hence  it  is  clear 
why  some  diseases  are  common  in  boys,  the  indolent  young 
women  and  certain  artizans."  In  forming  his  system, 
Boerhaave  was  not  unmindful  of  the  doctrines  of  Hoff- 
mann, and  particularly  of  the  influence  which  the  brain 
and  nerves  exercise  over  the  operations  of  the  animal 
economy,  altho  he  never  fully  appreciated  their  power. 

In  therapeutics,  besides  his  efforts  to  sweeten  the  acid, 
to  purify  the  stomach,  and  to  get  rid  of  the  acridities, 
Boerhaave  claimed  Hippocrates  and  Sydenham  as  his 
models,  but  without  being  by  any  means  exempt  from 
hypotheses  in  his  determination  of  the  indications.  He 
was,  however,  for  his  time,  comparatively  simple  in  his 
actual  therapeutic  prescriptions,  altho  the  latter  were  often 
enough  odd  in  their  character,  as  the  blood  of  birds  of 
prey.  His  medicines  were,  at  all  events,  less  effective  than 
his  personal  presence,  which  indeed  is  true,  'mutatis 
mutandis/  of  all  treatment.  It  was  Boerhaave  who  first 
permanently  established  the  clinical  method  of  instruction, 
and  its  diffusion  was  due  to  his  pupils,  particularly  Haller 
and  Van  Swieten.  His  influence  in  a  medico-historical 
point  of  view  is  greater  than  his  real  scientific  importance 
would  warrant. 

George  Stahl  (1660-1734),  a  profound  thinker,  founded 
a  system  distinctly  independent.  It  is  dynamico-organic, 
pietistic  and  antagonistic.  He  makes  the  soul  or  'anima' 
the  supreme  principle.  Stahl  put  forward  and  brilliantly 
maintained  the  view  that  all  the  chemical  events  of  the 
living  body,  even  tho  they  might  superficially  resemble, 


214  MEDICINE 

were  at  the  bottom  wholly  different  from  the  chemical 
changes  taking  place  in  the  laboratory,  since  in  the  living 
body  all  chemical  changes  were  directly  governed  by  the 
sensitive  soul,  'anima  sensitiva/  which  pervaded  all  parts 
and  presided  over  all  events.  This  resembles  the  "archeus" 
of  Van  Helmont.  His  fundamental  positon  is  that  between 
living  things,  so  long  as  they  are  alive,  however  simple,  and 
non-living  things,  however  composite,  however  complex  in 
their  phenomena,  there  is  a  great  gulf  fixed.  The  former, 
so  long  as  they  are  alive,  are  actuated  by  an  immaterial 
agent,  the  sensitive  soul;  the  latter  are  not.  Further,  the 
living  body  is  fitted  for  special  ends  and  purposes;  the 
living  body  does  not  exist  for  itself;  it  is  constituted  to  be 
the  true  and  continued  minister  of  the  soul.  The  body  is 
made  for  the  soul;  the  soul  is  not  made  for  and  is  not  the 
product  of  the  body.  When  the  body  is  diseased,  the 
symptoms  are  the  manifestation  of  the  soul  trying  to 
restore  normal  movements  in  the  organism. 

As  Baas  says:  "With  this  object  the  soul  is  frequently 
compelled  to  make  powerful  exertions.  As  the  soul  ordi- 
narily employs  the  circulation  and  the  capacity  of  the  parts 
of  the  body  for  contraction  and  relaxation  (tonus)  as 
the  route  and  instrument  of  its  influence  upon  the  body,  so 
also  in  disease,  where,  in  consequence  of  the  necessarily 
hastened  and  increased  activity  of  the  soul,  either  the 
pulse  is  accelerated,  the  temperature  rises,  etc.,  in  a  word, 
'fever'  makes  its  appearance,  or  spasmodic  movements, 
'convulsions/  are  developed.  In  the  false  movements 
within  the  organism  lies  also  the  main  cause  of  sicknesses, 
but  not  in  the  numerous  external  influences  assumed  by 
others.  Were  the  latter  the  case,  the  frequency  of  sick- 
ness and  the  number  of  diseases  would  necessarily  be 
much  greater  than  they,  in  fact,  are. 

"Since,  too,  the  soul  governs  the  organisms  chiefly  by 
way  of  the  circulation,  disturbances  and  stagnation  in  the 
latter  are  also  main  causes  of  disease.  These  disturbances 
arise  most  frequently  from  'plethora/  which  plays  an 


THE  PERIOD  OF  SYSTEMATIZATION      215 

important  role  in  the  system  and  the  therapeutics  of 
Stahl.  To  get  rid  of  this  plethora,  the  soul  employs  the 
means  mentioned  above;  either  fever,  with  its  heat,  by 
which  the  blood  is  imperceptibly  driven  out  or  dissolved, 
or  convulsive  movements,  by  which  the  blood  is  driven  into 
certain  parts  and  there  visibly  discharged. 

'In  childhood,  plethora  produces  a  pressure  of  blood 
toward  the  head,  and  the  soul,  as  a  compensation  for  this, 
provides  a  hemorrhage  from  the  nose.  During  youth  this 
blood-pressure  is  directed  rather  toward  the  chest,  and  is 
equalized  by  hemoptysis  and  pneumorrhagia  and  bleeding 
'piles/  which  Stahl  considers  a  safety-valve  of  the  utmost 
importance.  From  this  time  dates  the  very  high  estima- 
tion of  'hemorrhoids'  and  'hemorrhoidal  impulses/  the 
'hemorrhoidal  flow'  which  prevailed  among  physicians 
until  a  very  recent  period,  and  is  the  rule  among  the  laity 
even  at  the  present  day.  When  this  hemorrhoidal  flow 
stagnates,  it  is  by  all  means  to  be  again  started  up.  In  the 
stoppage  of  this  flow  lie  the  chief  causes  of  hypochondria 
and  melancholy,  as  well  as  of  all  chronic  diseases." 

"Fever,  as  we  have  seen,  was  for  Stahl  a  salutary 
effort  of  the  soul  to  preserve  the  body.  This  was  true  even 
of  intermittent  fever  (seen  in  malaria),  and  accordingly 
he  never  suppressed  this  disease  with  cinchona.  On  the 
other  hand,  inflammation  was,  in  his  view,  a  stagnation 
of  the  blood  (an  iatro-mechanical  idea — and  such  ideas  are 
accepted  by  him  also  in  other  directions),  under  the  forms 
of  erysipelas,  phlegmon  and  its  suppuration." 

Stahl  scorned  anatomy  and  physiology,  thinking  them 
beneath  his  dignity,  and  swore  boldly  by  the  maxim  that 
good  theorists  (among  whom  he  was  one  of  the  chief) 
may  be  bad  practitioners.  He  says,  in  sarcasm :  "The 
structure  of  the  meandering  passages  in  the  ear,  of  the 
anvil,  the  hammer,  and  the  stirrup  and — what  a  noble  dis- 
covery! — the  round  ossicle  (all  bones  for  the  mechanism 
of  hearing),  if  it  were  unknown,  would  render  the  physi- 
cal knowledge  of  the  body  very  defective.  But  medicine, 


2i6  MEDICINE 

that  is,  practical  medicine,  profits  by  this  knowledge  pre- 
cisely as  much  as  by  the  knowledge  of  the  snow  which  fell 
ten  years  ago !" 

In  therapeutics,  Stahl  placed  at  the  head  the  healing 
power  of  nature,  which  is  identical  with  his  "soul."  "It 
is  the  simple  truth  that  man  has  his  physician  in  himself, 
that  nature  is  the  physician  of  diseases  and  offers  a  better 
prospect  of  curing  diseases  than  the  most  successful  appa- 
ratus of  our  art."  For  the  rest,  he  follows  his  system  here, 
too,  with  the  utmost  strictness.  The  soul,  as  it  is  the 
cause  of  all  diseases,  so  is  it  that  which  cures  them  all. 
Therapeutics  can,  or  rather  should,  act  upon  this  alone; 
that  is,  upon  the  "movements"  occasioned  by  it.  If  too 
strong,  they  must  be  restrained;  if  too  feeble  or  utterly 
wanting,  we  must  endeavor  to  strengthen  them  or  to  call 
them  forth. 

Venesection,  of  which  Stahl  made  excessive  use  in  acute 
as  well  as  in  chronic  cases,  is  to  be  considered  the  main 
check  upon  these  movements.  He  even  recommended  vene- 
section as  a  preventive  or  prophylactic  measure  twice  a 
year,  and  by  it  the  people  have  been  served  and  injured 
down  to  modern  times.  Beside  venesection  he  ranked 
care  to  reestablish  the  hemorrhoidal  flow  by  the  use  of 
irritating  drugs,  which  Stahl  in  other  circumstances  dis- 
carded. To  these  measures  were  added  his  "balsamic  pills" 
(aloes,  hellebore,  etc.),  stomach-powder,  etc.,  rostrums 
which  brought  him  a  lucrative  business.  In  addition  Stahl 
gave  purgatives  and  emetics,  diaphoretics  and  especially 
alteratives,  including  his  favorite  saltpeter.  He  discarded, 
however,  many  effective  drugs  (and  particularly  the  poi- 
sons), above  all  the  Cinchona"  (because  by  its  astringent 
properties  it  suppressed  the  febrile  state,  which  was  in 
itself  sanative),  opium  and  ferruginous  preparations  and 
mineral  waters,  because  Hoffmann  recommended  them. 

Stahl's  teaching,  as  summarized  by  Foster,  was  briefly 
this :  "Learn  as  much  as  you  can  of  chemical  and  physical 
processes,  and  in  so  far  as  the  phenomena  of  the  living 


THE  PERIOD  OF  SYSTEMATIZATION      217 

body  exactly  resemble  chemical  and  physical  events  occur- 
ring in  non-living  bodies,  you  may  explain  them  by  chemi- 
cal and  physical  laws.  But  do  not  conclude  that  that  which 
you  see  taking  place  in  a  non-living  body,  will  take  place 
in  a  living  body,  for  the  chemical  and  physical  phenomena 
of  the  latter  are  modified  by  the  soul.  The  events  of  the 
body  may  be  rough  hewn  by  chemical  and  physical  forces, 
but  the  soul  will  shape  them  to  its  own  ends  and  will  do 
that  by  its  instrument,  motion." 

It  was  the  reaction  against  the  exclusively  mechanical 
and  chemical  theories  of  the  seventeenth  century  and  has 
fulfilled  its  mission  in  the  history  of  culture.  As  Spiess 
says  in  defense  of  Stahl's  theories,  "It  was  enough  for 
Stahl,  in  contrast  to  his  contemporaries,  who  were  all  too 
prone  to  utilize  the  laws  of  mechanics  then  alone  known 
and  the  trifling  chemical  knowledge  of  that  period,  of 
which  they  were  proud,  and  which  they  employed  entirely 
too  extensively  in  the  explantion  of  the  phenomena  of  life 
— it  was  sufficient,  I  say,  for  Stahl  to  have  rescued  life  as 
a  specific  active  force,  at  least  for  organized  beings."  He 
thus  stands  forth  as  the  founder  of  'animism/  which  doc- 
trine, tho  his  sensitive  soul  fell  back  later  to  the  lower 
stage  of  'a  vital  principle/  maintained  itself  in  many  minds 
through  the  two  succeeding  centuries  and  exists  at  the 
present  day. 

Friedrich  Hoffmann  (1660-1742)  was  the  founder  of  the 
so-called  Mechanico-dynamic  System,  which  was  held  in 
high  esteem  by  the  most  eminent  physicians  of  that  time. 
The  train  of  thought  in  Hoffmann's  system  is  as  follows : 
"Our  knowledge  is  finite,  rooted  in  the  senses  and  limited 
to  what  is  perceptible  by  the  senses ;  all  final  causes,  how- 
ever, are  inscrutable.  Forces  and  influences  beyond  the 
range  of  the  senses,  cognizable  by  metaphysical  specula- 
tion, lie  without  its  limits.  Forces  are  inherent  in  matter 
and  express  themselves  as  mechanical  movements,  deter- 
minable  by  mass,  number  and  weight.  In  the  body  also 
these  forces  express  themselves  by  movement,  as  action 


2i8  MEDICINE 

and  reaction,  contraction  and  relaxation,  'tonus/  Life 
is  movement,  especially  movement  of  the  heart ;  death  the 
cessation  of  the  movements  of  this  organ,  as  the  result  of 
which  putrefaction  begins.  Death  and  life  are  mechanical 
phenomena.  Health  is  synonymous  with  the  regular  oc- 
currence of  the  movements;  disease  a  disturbance  of  the 
same.  The  contraction  of  the  heart,  the  blood-vessels  and 
animated  fibers  set  in  the  motion  the  circulation  of  the 
blood  and  effect  regular  secretion  and  excretion,  the  chief 
phenomena  of  health.  Digestion  is  the  solution  of  food 
by  means  of  the  saliva  and  warmth,  perspiration  an  effect 
of  heat  alone,  and  takes  place  not  only  through  the  pores, 
but  also  through  the  smallest  vessels  of  the  skin. 

"The  body  is  precisely  like  a  hydraulic  machine.  Its 
movements  are  effected  and*  maintained  by  that  dynamico- 
material  principle  of  fluid,  but  extremely  volatile,  consti- 
tution, 'the  ether'  (synonymous  with  nervous  ether,  ner- 
vous spirit,  'sensitive  soul/  the  pneuma  of  the  ancient 
physicians).  This  acts  in  accordance  with  the  laws,  not 
of  ordinary  mechanics  but  of  a  higher  and  still  uninvesti- 
gated  science,  and  is  in  very  small  part  derived  from  the 
atmosphere,  but  chiefly  secreted  from  the  blood  in  the 
brain.  The  'movements*  of  the  latter  organ  drive  it,  by 
way  of  the  nerve  tubules,  throughout  the  whole  body.  This 
motor  principles  possesses  conception  and  sensation  and 
is  the  soul  which  alone  perceives  things.  It  forms  and 
maintains  the  body  in  accordance  with  its  idea,  and  each 
special  particle  of  it  has  a  conception  of  the  composition 
and  mechanism  of  the  body.  The  chief  reservoir  and  cen- 
ter of  the  ether  is  the  medulla  oblongata  at  the  base  of  the 
brain." 

Hoffmann's  therapy  was  simple  and  designedly  poor  in 
drugs  (according  to  the  ideas  of  that  time),  but  by  no 
means  free  from  theoretical  views.  The  physician  has, 
before  all  else,  to  regulate  the  disturbed  movements,  for 
nature  is  frequently  not  able  to  do  this.  But  there  are 
diseases  which  cure  other  diseases;  that  is,  fever  cures 


THE  PERIOD  OF  SYSTEMATIZATION      219 

spasms.  Hoffmann  divided  drugs  (which  he  held  worked 
under  mechanical  laws)  into  those  which  strengthen  or 
weaken,  alter  or  evacuate.  He  was  especially  partial  to 
the  use  of  his  own  remedies  and  wine,  particularly  Hoch- 
heimer,  which  he  considered  the  best  of  all  wines,  as  the 
English,  at  his  instance,  do  at  the  present  day.  Camphor 
he  strongly  recommended;  likewise  mineral  waters,  cold 
water,  Seidlitz  salt,  cinchona  and  iron.  He  often  practiced 
venesection  and  laid  great  stress  upon  the  observance  of 
prescribed  diet,  as  absolute  diet,  milk  diet,  wine  diet,  ex- 
ercise, etc.  Poisons  in  general  he  rejected;  the  prepara- 
tions of  lead  he  absolutely  discarded  for  internal  use  and 
desired  to  limit  the  employment  of  opium. 

William  Cullen  (1712-1790),  a  Scotchman,  was  at  first 
a  barber,  then  surgeon,  and  after  years  of  hardship  he 
finally  got  his  education  at  the  university.  Then  for  years 
he  was  a  professor  of  chemistry  and  medicine.  He  founded 
a  system  of  nervous  pathology.  The  main  foundation  of 
Cullen's  system  is  formed  by  the  living  solid  parts  of  the 
body,  not  the  fluids;  the  chief  agents  are  the  nerves.  An 
undefined  dynamic  something,  which  is  different  from 
Hoffmann's  material  ether  and  the  supernatural  soul  of 
Stahl  and  which  Cullen  calls  "the  nervous  force,"  "ner- 
vous activity,"  "the  nervous  principle,"  is  the  proper  life- 
giving  element.  He  also  calls  this  principle  "the  animal 
force"  or  "energy  of  the  brain,"  in  which  he  also  includes 
the  spinal  cord.  He  believed  that  the  soul  of  man  is 
inseparably  united  with  his  brain. 

The  nervous  principle  produces  spasm  and  atony.  The 
former  is  not,  however,  always  dependent  upon  increased 
nervous  activity,  but  may  also  originate  from  feebleness 
of  the  brain,  which  is  the  center  of  nervous  activity.  The 
nerves  are  the  conductors  of  the  activity  of  the  brain. 
Everything  is  effected  through  the  brain  and  the  nerves, 
and  everything,  including  the  causes  of  disease,  works 
upon  both  of  these.  The  causes  of  disease  are  chiefly  of  a 
debilitating  character,  but  they  awaken  reaction  and  the 


220  MEDICINE 

healing  power  of  nature.  Fever  is  such'  a  reparative  effort 
of  nature,  even  in  its  cold  stage,  and  its  cause  is  dimin- 
ished energy  of  the  brain,  often  united  with  a  kind  of 
delirium,  due  to  a  contemporaneous  spasm  of  the  extremi- 
ties of  the  vessels,  which  produces  a  reflex  acceleration  of 
the  heart  and  a  stimulation  of  the  arteries. 

The  blood  plays  no  part  in  fever,  which  is  excited  by 
weakening  influences,  as  fright,  cold,  intemperance,  the 
emanations  of  marshes  or  human  beings,  etc.  Besides 
the  spasm  of  the  vascular  extremities  and  the  feebleness 
of  the  brain,  there  is  also  an  accessory  atony,  which  is 
propagated  by  sympathy  to  the  tunics  of  the  stomach  and 
occasions  the  loss  of  appetite  associated  with  all  fevers. 
Both  spasm  and  atony  continue  until  the  brain  has  recov- 
ered its  ordinary  activity,  a  result  due  to  the  increased 
activity  of  the  heart,  and  recognised  by  the  establishment 
of  perspiration. 

Cullen's  explanation  of  the  gout  was  famous.  Accord- 
ing to  his  view,  this  disease  depends  upon  an  atony  of  the 
stomach  or  organs  of  digestion,  against  which  is  set  up 
periodically  a  reparative  effort  in  the  form  of  an  inflam- 
mation of  the  joints.  Gout  is  a  general  disease,  but  there 
is  no  gouty  material.  His  therapeutics  were  simple,  and, 
from  his  renunciation  of  the  previous  abuse  of  venesec- 
tion, they  were  very  salutary. 

Anton  de  Hae'n  (1704-1776),  of  The  Hague,  a  pupil 
of  Boerhaave,  was  the  founder  of  the  old  Vienna  school, 
a  union  of  Hippocrates,  Sydenham  and  Boerhaave.  Its 
chief  merits  are  in  its  practical  and  diagnostic  services 
and  in  its  generally  sober  observations.  He  believed,  like 
Hippocrates,  in  the  simplest  possible  treatment,  united 
with  careful  observation.  Nature  must  not  be  disturbed 
by  medicines  of  a  powerful  action.  He  warmly  embraced 
hygiene  and  prophylactic  views.  He  reintroduced  the 
thermometer  and  demonstrated  that  in  the  cold  stage  of 
fever  an  elevation  of  temperature,  often  considerable,, 
could  occur. 


THE  PERIOD  OF  SYSTEMATIZATION      221 

The  school  of  Montpellier,  led  by  Borden,  maintained 
the  existence  of  a  general  life  of  the  body,  which  resulted 
from  the  harmonious  working  of  the  individual  lives  and 
powers  of  all  its  organs.  These  organs  are  associated  one 
with  the  other,  but  each  has  a  different  function.  The 
most  important  organs  are  the  heart,  stomach  and  brain. 
These  regulate  the  life  of  the  other  organs.  From  them 
proceed  sensibility  and  motion,  the  two  chief  phenomena  of 
life.  The  nerves  are  the  chief  organs  which,  with  the 
brain  as  their  center,  distribute  and  regulate  motion  and 
sensation  throughout  the  body,  but  do  not  act  in  con- 
formity with  chemical  and  physical  laws.  The  stomach 
presides  over  nutrition,  the  heart  propels  the  blood  and 
chyle  through  the  body.  Health  is  the  undisturbed  circu- 
lation of  motion  and  sensation  from  and  to  the  three  cen- 
ters of  the  body.  There  is  no  such  thing  as  perfect  health, 
for  it  fluctuates  from  moment  to  moment.  Secretions  and 
excretions,  sleep  and  waking,  muscular  activity,  the  em- 
ployment of  the  external  and  internal  senses,  all  are  subor- 
dinated to  these  three  chief  organs. 

Animal  magnetism  was  a  theory  advanced  by  Franz 
Mesmer  (1734-1815),  later  called  mesmerism.  He  claimed 
that  there  was  some  "magnetic  fluid"  existing  everywhere 
throughout  the  world,  and,  of  course,  in  man  also,  and  this 
overflowed  from  the  hand  with  a  healing  influence  upon 
others,  and  that  the  sick  were  particularly  susceptible.  He 
erected  a  private  institution,  where  he  treated  simpletons 
and  credulous  old  ladies.  He  later  went  to  Paris,  where 
he  was  "the  rage"  for  a  long  while  and  to  the  betterment 
of  his  pocketbook.  Mesmerism  is  merely  the  application 
of  hypnotism,  such  as  may  be  practiced  by  any  one.  It  is 
the  result  of  a  play  on  the  imagination  of  the  patient,  who 
thereby  renders  himself  more  susceptible  to  suggestions 
which  the  hypnotist  may  offer.  It  has  lately  been  applied 
to  certain  forms  of  hysteria  and  nervousness  with  great 
-success. 

Galvanism  was  considered  the  genuine  "vital  force,"  the 


222  MEDICINE 

positive  pole  being  identified  with  irritability,  the  negative 
with  sensibility,  and  the  theory  was  carried  so  far  as  to 
declare  man  the  irritating  and  active  pole  and  woman  the 
sensitive  and  passive !  Galvani  himself  had  located  the 
seat  of  electricity  in  the  brain  and  he  held  that  by  means 
of  the  nerve-tubes  it  reached  the  whole  body  and  especially 
the  muscles,  producing  in  them  contractions  analogous  to 
the  accidentally  discovered  twitchings  of  the  frog.  Dis- 
ease was  the  disturbance  of  this  electricity  in  the  body. 

Chemical  and  physical  theories  arose  as  the  result  of  the 
advances  made  in  chemistry  and  physics.  The  Phlogistic 
Theory  is  the  theory  of  animal  heat.  According  to  this 
the  free  heat  existing  in  the  inspired  air  is  incorporated 
with  the  body  by  means  of  respiration,  and  at  the  same 
time  "phlogiston"  is  removed  from  the  blood.  Disease  is 
the  result  of  too  much  or  too  little  heat.  Against  this  arose 
the  Antiphlogistic  Theory,  in  which  the  newly  discovered 
oxygen  was  accepted  as  the  "vital  force."  Disease  de- 
pended upon  the  appropriation  of  too  much  or  too  little 
oxygen. 

The  Brunonian  System,  founded  by  John  Brown  (1735- 
1788),  was  the  most  brilliant  of  the  eighteenth  century. 
According  to  Brown,  life  is  not  a  natural  condition,  but  an 
artificial  and  necessary  result  of  irritations  constantly  in 
action.  All  living  beings,  therefore,  tend  constantly  to- 
ward death.  That  irritations  can  compel  life  is  their  char- 
acteristic. Living  beings,  too,  are  capable  of  excitability, 
which  is,  indeed,  inscrutable  in  its  nature,  but  its  seat  in 
the  muscles  and  the  medulla  of  the  nerves  may  be  demon- 
strated. The  latter  is  the  cause  of  the  processes  which 
take  place  in  the  body,  whether  sound  or  diseased,  and  con- 
sequently of  life  itself. 

Irritations  are  of  two  kinds,  external  and  internal.  To 
the  external  belong  food,  blood,  the  fluids  in  general, 
warmth,  air,  etc.;  the  functions  of  thought,  feeling,  mus- 
cular activity,  etc.,  are  to  be  considered  internal  irritations, 
which  have  the  same  action  as  the  external.  Moreover, 


THE  PERIOD  OF  SYSTEMATIZATION      223 

irritations  are  general  or  local.  General  irritations  arouse 
excitement  in  the  whole  body ;  the  local  act  first  of  all  upon 
an  individual  part  and  subsequently  upon  the  whole  body. 
Health  is  an  intermediate  grade  of  excitement,  diseases 
too  high  or  too  low  a  grade.  The  two  are  not  conditions 
substantially  different,  but  simple  gradations  of  one  and 
the  same  action  upon  the  excitability. 

Excitement  is  divided  into  different  grades  according  to 
the  degree  of  action  of  the  irritation.  The  extreme  grades 
of  this  scale  are  like  the  exhaustion  and  accumulation  of 
irritability  as  the  result  of  too  great  or  too  little  power  of 
the  irritants  and  are  death.  The  intermediate  result  is 
ordinarily  weakness  (asthenia),  either  direct  or  indirect. 
Direct  asthenia  depends  upon  the  presence  of  an  excess  of 
excitability,  accordingly  upon  too  great  an  accumulation 
of  excitability  the  result  of  a  deficiency  of  irritation.  It  is 
to  be  removed  by  new  irritations,  which  reduce  that  excess 
to  the  normal  proportion  of  health.  Indirect  asthenia  is 
to  be  referred  to  an  excess  of  irritation,  by  which  excitabil- 
ity becomes  exhausted.  It  is  to  be  relieved  by  opposing  a 
weaker  irritation  to  the  too  strong  causative  irritation. 
The  grades  of  excitability  are  always  in  inverse  proportion 
to  the  excitement.  Most  diseases  are  dependent  upon 
asthenia.  Sthenia  is  more  rarely  a  cause  of  disease  and 
is  the  result  of  a  less  powerful  irritation. 

Brown's  diagnosis  requires  no  special  symptomatology, 
but  simply  a  consideration  of  the  antecedent  injuries  and 
the  earlier  condition  of  the  health,  without  any  distinction 
between  local  and  general  diseases.  It  demands  only  the 
determination  of  the  grade  of  diseases  in  accordance  with 
the  strength  or  weakness  of  the  acting  irritation.  For  this 
purpose  some  pupils  of  Brown  drew  up  a  kind  of  barome- 
ter of  disease. 

Like  the  system  of  Asclepiades,  with  those  views 
(Methodism)  Brown's  doctrine,  setting  aside  its  change  of 
terms,  has  the  greatest  similarity,  the  Brunonian  system 
held  substantially  the  position  that  it  is  not  nature  which 


224  MEDICINE 

cures  diseases  but  the  physician.  The  latter  must  continue 
to  irritate  or  weaken  until  the  medium  height  of  the 
barometer  of  irritation  is  again  reached.  Of  all  the  thera- 
peutic methods,  that  of  Brown  is  the  one  most  deeply 
sunken  in  theory,  from  which  even  the  nearly  allied  system 
of  Asclepiades  was  more  exempt.  It  was  a  fatal  principle 
when  applied  to  practice.  For  how  could  one  recognise, 
and  by  what  means  could  he  bring  about,  the  medium 
height  of  the  barometer  of  irritation  ?  One  should  always 
aim  at  general  effects  and  not  desire  those  of  a  local  char- 
acter, and  with  this  object  in  view,  he  should  not  limit 
himself  to  a  single  remedy,  but  rather  employ  several  that 
"the  excitability  may  be  attacked  generally  and  uniformly." 
The  'materies  morbi'  furnishes  no  indications  for  the  treat- 
ment. The  physician  need  not  work  for  its  expulsion,  but 
merely  allow  it  time  to  leave  the  body. 

The  pure  Brunonian  system,  in  comparison  with  other 
far  less  logical  and  ingenious  theories,  won  immediately 
after  its  announcement  only  a  few  partizans  and  opponents, 
however  great  was  the  attention  which  it  aroused  on  its 
publication.  Perhaps  the  important  occurrences  of  the 
period  may  have  been  partially  responsible  for  this — an 
explanation  which  applies  with  particular  force  to  France 
— but  the  disagreeable  characteristics  of  its  founder  and 
the  countermining  of  his  enemies  (especially  the  highly 
esteemed  Cullen)  contributed  their  share. 

Philippe  Pinel  (1745-1826)  founded  a  theory  called 
Realism.  He  is  famous  for  the  efforts  he  made  to  improve 
the  conditions  of  the  insane  and  for  his  study  and  treat- 
ment of  mental  diseases.  Pinel  became  of  great  impor- 
tance in  the  development  of  general  medicine  by  his 
principle  of  substituting  exclusively  the  analytic,  or  so- 
called  natural-scientific,  method  for  the  synthetic  method 
heretofore  in  vogue.  He  sought  to  determine  diseases  by 
a  diagnosis  carefully  constructed  from  the  symptoms,  a 
thing  which  he  considered  easy.  He  desired  further  to 
classify  them  in  accordance  with  their  pure  symptoms,  a 


THE  PERIOD  OF  SYSTEMATIZATION      225 

matter  which  he  regarded  as  practicable,  inasmuch  as  he 
considered  "disease"  a  simple,  indivisible  whole,  composed 
of  chief  symptoms,  following  each  other  with  perfect 
regularity,  and  varying  only  in  unessential  collateral  phe- 
nomena, and  capable  of  classification  like  the  objects  of 
the  natural  sciences.  Perhaps  the  artificial  classifications 
of  Linneus  and  others  may  have  supplied  him  with  models. 
Pathological  anatomy  he  subordinated  to  the  symptoms. 
Pinel,  accordingly,  regarded  even  fever  as  something 
essential.  His  classes,  in  the  second  place,  are  arranged 
according  to  the  tissues.  He  divides  diseases  into  fevers, 
inflammations,  active  congestions,  neuroses,  diseases  of 
the  lymphatics  and  the  skin,  and  undetermined  diseases. 
It  is  interesting  to  notice  that  altho  the  eighteenth 
century  was  replete  with  systems  and  theories,  they  were 
not  new  ones  and  did  not  materially  advance  medicine  or 
save  human  life.  The  systems  were  almost  invariably 
based  upon  the  theories  of  the  preceding  centuries,  but 
the  great  error  of  these  men  lies  in  the  fact  that  they  did 
not  appreciate  that  medicine,  as  the  science  of  both 
healthy  and  morbid  life,  like  life  itself,  cannot  be  com- 
pressed into  a  system. 


CHAPTER  VIII 

THE  CONTRIBUTIONS  OF  THE  PRACTITIONER 

THE  steady  advance  of  medicine  and  its  allied  sciences 
depended  not  so  much  on  the  great  number  of  systems 
and  theories  that  were  springing  up  here  and  there,  but 
upon  the  many  physicians  who  shunned  the  ostentation 
of  creating  new  systems.  These  were  the  men  working1 
along  steadily,  either  in  the  laboratories  on  anatomy, 
physiology  and  chemistry,  or  at  the  clinics  and  bedsides, 
seeking  always  a  way  to  alleviate  pain  and  to  cure  disease. 
One  of  the  latter  was  Auenbrugger  (1722-1809),  who  in 
his  own  words  can  best  describe  his  services  to  practical 
medicine: 

"I  here  present  the  reader  with  a  new  sign  which  I 
have  discovered  for  detecting  diseases  of  the  chest.  This 
consists  in  the  percussion  of  the  human  thorax,  whereby, 
according  to  the  character  of  the  particular  sounds  thence 
elicited,  an  opinion  is  formed  of  the  internal  state  of  that 
cavity.  In  making  public  my  discoveries  respecting  this 
matter  I  have  been  actuated  neither  by  an  itch  for  writing, 
nor  a  fondness  for  speculation,  but  by  the  desire  of  sub- 
mitting to  my  brethren  the  fruits  of  seven  years'  observa- 
tion and  reflection.  In  doing  so,  I  have  not  been  uncon- 
scious of  the  dangers  I  must  encounter;  since  it  has  been 
the  fate  of  those  who  have  illustrated  or  improved  the 
arts  and  sciences  by  their  discoveries  to  be  beset  by  envy, 
malice,  hatred,  detraction  and  calumny.  This,  the  com- 
mon lot,  I  have  chosen  to  undergo ;  but  with  the  determina- 

226 


CONTRIBUTIONS  OF  PRACTITIONERS     227 

tion  of  refusing  to  every  one  who  is  actuated  by  such 
motives  as  these  all  explanation  of  my  doctrines.  What 
I  have  written  I  have  proved  again  and  again,  by  the 
testimony  of  my  own  senses,  and  amid  laborious  and 
tedious  exertions;  still  guarding,  on  all  occasions,  against 
the  seductive  influence  of  self-love." 

His  invention  was  of  great  diagnostic  importance  in 
diseases  of  the  chest,  but  its  significance  was  not  grasped 
until  many  years  later.  Altho  the  ear  had  been  em- 
ployed in  auscultation  and  in  the  percussion  of  tympanites 
and  ascites  as  far  back  as  the  ancients,  no  diagnosis  of 
the  diseases  of  the  great  viscera  had  been  attempted  in 
this  way. 

Diseases  of  the  intestines  were  not  much  described,  as 
the  hemorrhoids  and  portal  stagnation  of  Stahl  were  still 
strongly  accepted.  Diseases  of  the  peritoneum  were  first 
studied  by  Morgagni  and  Walter.  Diseases  of  the  lungs 
were  studied,  but  not  successfully,  being  long  obscure. 
"Dropsy  of  the  chest"  included  many  diseases  which  could 
not  be  separated  from  one  another,  as  emphysema,  hydro- 
thorax,  etc.  Catarrh  of  the  lungs  and  the  bronchi  were 
not  differentiated,  nor  pleurisy  and  pneumonia,  both  being 
called  peripneumonia,  as  in  the  days  of  Hippocrates.  Mor- 
gagni was  the  first  to  clear  these  up. 

Tuberculosis  of  the  lungs  was  only  fairly  understood. 
Some  of  the  English  thought  consumption  due  to  an 
excess  of  oxygen  in  the  lungs,  and  proposed  to  offset  it 
with  inhalations  of  carbonic  acid  gas.  Diseases  of  the 
heart,  pericardium  and  aneurisms  were  studied  by  Mor- 
gagni, but  not  much  advance  made.  Diseases  of  the 
nervous  system  were  carefully  studied.  Neuralgia  of  the 
face  was  known  (also  by  the  Arabians)  and  treated  with 
electricity. 

Diseases  of  the  brain  were  developed  a  little.  Morgagni 
first  wrote  of  "meningitis."  Robert  Whytte  told  of 
"water  on  the  brain."  Hoffmann  demonstrated  the  blood- 
clot  in  the  brain  of  a  person  who  died  from  apoplexy. 


228  MEDICINE 

Epilepsy  was  studied  by  Tissot.  St.  Vitus'  dance  and 
hysteria  were  examined.  The  diseases  of  children  re- 
ceived much  attention.  The  anemias  were  described  and 
better  understood.  Scurvy  and  gout  were  written  about. 
Haller,  by  the  injection  of  putrefying  matter  into  the 
veins,  proved  the  existence  of  "septic"  poisoning,  and 
prepared  the  way  for  the  doctrine  of  septicemia.  Pole 
and  Dobson  found  sugar  in  the  urine  of  diabetics. 

Surgery  attained,  in  this  century,  the  rank  of  equality 
with  so-called  internal  medicine,  not  only  from  the 
scientific,  but  also  from  the  practical  standpoint.  Its 
higher  representatives  received  the  same  social  rank. 
The  impulse  to  all  this  advance  again  proceeded  from 
France,  the  headquarters  of  modern  surgery.  The  sur- 
geons of  this  time  took  up  ophthalmology  very  extensively 
and  cultivated  it  to  such  a  degree  that  it  soon  became  a 
specialty  of  high  rank,  practiced  by  eminent  men.  It 
had  up  to  this  point  been  in  the  hands  of  the  charlatans. 
The  English  surgeons  were  famous  for  skill  and  daring 
and  much  of  the  advance  is  due  to  their  good  work. 

The  surgeons  helped  advance  not  only  operative  tech- 
nique, but  also  anatomy  and  physiology.  Cheselden, 
White,  the  Hunters  and  Bell  were  among  those  who  made 
the  English  famous  for  surgery.  Obstetrics  was  even 
more  thoroughly  cultivated  than  surgery.  It  was  sep- 
arated from  surgery  and  assumed  the  dignity  of  a  spe- 
cialty, due  mainly  to  the  excellent  work  of  the  French. 

There  had  been  such  an  upheaval  in  the  study  of 
anatomy  in  the  preceding  century,  that  there  was  not  very 
much  more  to  investigate.  But  it  was  studied  constantly 
and  thoroughly,  there  being  frequent  additions  to  anatom- 
ical knowledge,  of  the  more  minute  and  less  striking  parts. 
The  relation  of  anatomy  to  physiology  was  better  appre- 
ciated, and  anatomy  began  to  be  studied  from  that  stand- 
point. Microscopic  anatomy,  also,  was  quiet  as  compared 
with  the  preceding  century.  Pathological  and  general 
anatomy  were  newly  created. 


CONTRIBUTIONS  OF  PRACTITIONERS     229 

A  still  more  important  acquisition  of  the  eighteenth  cen- 
tury in  the  fundamental  sciences  of  medicine  was  the 
revival  and  study  of  experimental  physiology.  This  re- 
vival, which  marks  an  epoch  in  the  history  of  medicine, 
was  effected  by  Albert  von  Haller  (1708-1777),  of  Berne,, 
a  distinguished  scholar  and  thinker,  a  poet,  botanist  and 
statesman.  His  anatomical  discoveries  were  made  while 
working  out  his  chief  doctrines.  He  enriched  the  anatomy 
of  the  heart,  while  studying  his  doctrine  of  irritability  in 
reference  to  that  organ.  He  showed  that  the  dura  mater 
or  covering  of  the  brain  formed  the  venous  sinuses, 
and  he  thought  the  dura  had  no  nerves  in  it;  he  studied 
the  structure  of  the  uterus  and  showed  it  was  a  muscular 
organ. 

Of  the  highest  importance  were  his  researches  on  the 
mechanics  of  respiration,  on  the  formation  of  bone,  and 
on  the  development  of  the  embryo ;  the  latter  indeed 
stands  out  as  the  most  conspicuous  piece  of  work  on  this 
subject  between  Malpighi  and  Von  Baer,  tho  marred 
by  the  theoretical  speculations  attached  to  it.  What  is, 
perhaps,  his  greatest  work,  was  the  establishment  of  the 
doctrine  of  muscular  irritability.  In  dealing  with  each 
division  of  physiology  he  carefully  describes  the  ana- 
tomical basis,  including  the  data  of  minute  structure, 
physical  properties,  and  chemical  composition  so  far  as 
these  were  then  known. 

In  the  physiology  of  the  circulation,  he  studied  the 
mechanism  of  cardiac  motion.  He  believed  that  the 
internal  mechanism  was  due  to  irritation,  and  on  this 
based  his  Doctrine  of  Irritability. 

In  his  physiology  of  digestion,  he  departed  from  his 
predecessors.  According  to  him,  saliva  is  neither  acid  nor 
alkaline ;  and  so  far  from  attributing  to  it  the  great  virtues 
claimed  for  it  by  Sylvius  and  Stahl,  he  seems  to  regard  its 
great  use  as  being  that  of  softening  the  food  and  helping 
deglutition. 

Dwelling  on  the  difficulty  of  obtaining  gastric  juice  in 


230  MEDICINE 

the  pure  condition,  noting  that  acidity  is  often  a  token  of 
the  onset,  and  alkalinity  of  the  advance  of  putrefaction, 
he  concludes  that  pure  gastric  juice  is  neither  acid  nor 
alkaline;  and  while  speaking  of  it  as  a  macerating  liquor 
which  softens  and  dissolves  the  food,  he  refuses  to  regard 
it  as  a  ferment.  It  is  not  a  corrosive  liquid,  as  are  many 
acids,  and  tho  it  may  be  at  times  acid,  the  acidity  is  a 
token  of  the  degeneration  of  the  digested  food,  not  of 
digestion  itself,  which  "imparts  to  the  food  a  wholesome 
animal  nature" — i.e.,  gives  it  the  beginning  of  vitality ;  and 
the  characteristic  of  living  animal  tissues  is,  he  urges, 
alkalinity  rather  than  acidity. 

Trituration  he  regards  as  a  useful  aid,  especially  where 
hard  grains  form  a  part  of  food,  as  in  that  of  birds,  but 
only  an  aid.  "They  have  done  well  who  have  brought 
back  to  its  proper  mediocrity  the  power  of  trituration  so 
immensely  exaggerated."  Bile  he  insists  is  not,  as  some 
have  thought,  a  mere  excrement.  Retained  for  a  while, 
and  slightly  altered  during  its  stay  in,  but  not  formed  by 
the  gall-bladder,  secreted,  on  the  contrary,  by  the  sub- 
stance of  the  liver,  partly  perhaps  from  the  blood  supplied 
by  the  hepatic  artery  but  mainly  from  that  of  the  vena 
porta,  bile  is  a  fluid  viscid  and  bitter,  but  not  acid,  and 
indeed  not  alkaline,  a  fluid  which,  as  all  know,  has  the 
power  of  dissolving  fat  and  so  acts  on  a  mixture  of  oil 
and  water  as  to  form  out  of  them  an  emulsion;  it  thus 
dissolves  all  the  food  into  chyle.  This  view  is  almost 
entirely  correct. 

The  old  idea,  handed  down  from  the  ancients,  that  the 
mechanism  of  respiration  was  due  to  the  lungs  contract- 
ing independently,  he  fought  against,  as  he  did  not  believe 
that  air  existed  in  the  pleural  sac,  which  would  be  neces- 
sary if  the  equilibrium  be  maintained  in  and  outside  the 
lungs.  The  most  brilliant  contribution  of  Von  Haller  to 
the  physiology  of  the  nervous  system  was  his  refutation 
of  the  doctrine  of  oscillatory  motion  of  the  nerves,  and  his 
administration  of  the  death-blow  to  the  doctrine  of  vital 


CONTRIBUTIONS  OF  PRACTITIONERS     231 

spirits.  Haller  proved  that  sensation  takes  place  in  the 
nerves,  or  in  organs  which  contain  nerves. 

Glisson  taught  "irritability  of  the  fiber''  as  well  as  of 
the  fluids,  under  the  influence  of  external  and  internal 
irritation — a  doctrine  which  he  discovered  by  the  deductive 
method.  But  Haller  proceeded  to  follow  up  this  principle 
by  the  inductive  method,  proving  its  existence  by  experi- 
ment. But  in  contrast  to  Glisson,  he  demonstrated  that 
this  irritability  was  something  entirely  special,  a  simple 
peculiarity  of  muscular  substance,  and  differing  from 
sensation.  He  showed  that  muscle  tissue  will  contract 
(being  irritable)  even  when  no  nerves  go  to  it,  and  set 
up  a  long  dispute  as  to  whether  nerve  or  muscle  involved 
the  contraction.  It  must  not  be  forgotten  that  in  all  his 
researches,  Von  Haller  did  not  have  the  aids  and  acces- 
sories of  modern  physiologists,  so  that  he  deserves  the 
more  credit  for  his  great  work. 

Pathological  Anatomy  was  established  by  Morgagni,  of 
Italy  (1682-1772).  He  was  the  first  to  devote  attention 
extensively  and  thoroly  to  the  anatomical  products  of 
common  diseases.  Prior  to  him,  only  the  rare  and  very 
evident  lesions  of  disease  were  noted  and  discussed.  He 
studied  the  clinical  pictures,  the  history  of  the  symptoms, 
and  the  course  of  the  disease  as  well,  thus  making  his 
observations  complete.  He  erred,  however,  in  regarding 
the  products  of  diseases  as  their  cause.  He  showed  how 
important  it  is  to  know  the  steps  in  the  pathological  con- 
ditions of  any  organs  in  a  disease,  how  it  aids  in  diagnosis 
of  the  affection,  and  how  it  helps  in  the  treatment.  He 
was  the  first  to  appreciate  a  nervous  reflex,  especially  that 
of  sneezing,  although  he  knew  nothing  of  the  sympathetic 
nervous  system. 

Morgagni  studied  the  action  of  alcohol  on  the  human 
system.  He  pointed  out  that  the  excitation  of  the  heart 
was  due  to  reflex  action,  following  overdistention  of 
the  arteries.  This  overdistention,  or  increased  tension, 
led  to  degenerations  in  the  arterial  walls.  Thus  he  inves- 


232  MEDICINE 

tigated  aneurism  and  showed  the  changes  that  take  place 
in  an  artery  thus  diseased,  and  he  recommended  special 
and  careful  diet  as  a  treatment  for  early  aneurism.  In 
the  study  of  tuberculosis,  he  was  most  penetrating.  He 
insisted  that  it  was  contagious,  and  he  believed  in  it  to 
the  extent  of  refusing  to  do  autopsies  on  that  disease.  He 
taught  and  believed  in  the  early  operation  for  the  treat- 
ment of  cancer.  He  was  a  strong  opponent  to  venesection. 

General  Anatomy  was  founded  by  Marie  Bichat  (1771- 
1802).  He  was  a  great  teacher  of  anatomy.  Through  his 
wonderful  mental  fertility  and  power,  and  in  spite  of  his 
early  death,  he  wrote,  in  the  few  years  of  his  life,  a  great 
number  of  important  works — they  include  nine  volumes. 
As  an  evidence  of  Bichat's  enormous  activity  it  may  be 
stated  that  in  a  single  winter  he  examined  700  bodies.  His 
chief  works  were  the  "Traite  des  membranes"  (1800), 
"Anatomie  generate"  (1801)  and  "Anatomie  patholo- 
gique." 

From  Bichat's  general  and  pathological  anatomy  a  new 
tendency  in  medicine — that  tendency  which  it  manifests 
to-day — took  its  origin,  as  Baas  points  out.  Bichat's 
genius,  masterly  mental  power  and  charming  gracefulness 
of  exposition,  founded  chiefly  the  realistic  and  pathologico- 
anatomical  epoch.  He  uttered  the  famous  apothegm, 
"Take  away  some  fevers  and  nervous  troubles  and  all  else 
belongs  to  the  kingdom  of  pathological  anatomy." 

Bichat  established  the  tendency  of  similar  tissues  to 
similar  anatomical  forms  of  disease.  This  last  divi- 
sion is  connected  with  Bichat's  creation  of  general 
anatomy.  He  distinguished  general  tissue-systems, 
found  everywhere  in  the  body,  as  cellular  tissue,  the 
nervous  system  of  animal  and  organic  life,  the  arterial 
system,  the  venous  system,  the  system  of  exhalant  vessels 
and  lymphatics ;  and  special  tissue-systems,  peculiar  to 
certain  parts  exclusively,  as  the  osseous,  medullary,  cartila- 
ginous, fibrous  and  fibro-cartilaginous  systems,  the  animal 
and  vegetative  muscular  system,  system  of  serous  and 


CONTRIBUTIONS  OF  PRACTITIONERS     233 

mucous  membranes,  system  of  synovial  membranes,  glan- 
dular system,  dermoid  system,  epidermoid  system  and  the 
hairy  system.  These  twenty-one  tissues,  selected  without 
the  aid  of  the  microscope  (which  Bichat  did  not  employ), 
were  distinguished  as  simple  and  similar  elements  of  the 
body,  like  the  elements  of  chemistry,  and  like  the  cells 
which  Virchow  chose  for  his  elements.  They  were  as- 
signed to  general  anatomy,  while,  on  the  other  hand, 
descriptive  anatomy  had  to  do  with  their  different  com- 
binations. Thus,  according  to  Bichat,  the  stomach,  as  the 
subject  of  descriptive  anatomy,  is  composed  of  a  serous, 
mucous  and  organic  muscular  coat.  The  simple  mem- 
branes are  the  mucous,  serous  and  fibrous;  the  compound 
membranes  are  formed  by  juxtaposition  of  these,  and  are 
called  fibro-serous,  sero-mucous  and  fibro-mucous,  uniting 
in  themselves  one  or  more  of  the  properties  of  the  simple 
membranes. 

Bichat  overthrew  the  ontological  and  speculative  tend- 
ency of  medicine,  placed  "facts"  in  the  front  rank  and 
banished  ideas  and  "ideologists"  from  the  science.  "If  I 
have  gone  forward  so  rapidly,  the  result  has  been  that  I 
have  read  little.  Books  are  merely  the  memoranda  of 
facts.  But  are  such  memoranda  necessary  in  a  science 
whose  material  is  ever  near  us,  where  we  'have,  so  to 
speak,  living  books  in  the  sick  and  the  dead?"  "Let  us 
halt  when  we  have  afrived  at  the  limits  of  the  most  care- 
ful and  thoro  observation,  and  let  us  not  strive  to  press 
forward  where  experience  cannot  show  us  the  way" — a 
sentiment  which  certainly  does  not  accord  with  his  earlier 
vitalistic  views.  Bichat  was  the  first  who  claimed  for 
medicine  the  rank  of  an  "exact"  science.  "Medicine  was 
long  thrust  forth  from  the  bosom  of  the  exact  sciences. 
It  will  have  the  right  to  be  associated  with  them,  at  least 
as  regards  the  diagnosis  of  diseases,  as  soon  as  we  shall 
everywhere  have  united  with  the  most  thoro  and  rigorous 
observation,  the  investigation  of  those  changes  which  our 
organs  suffer." 


234  MEDICINE 

In  the  course  of  the  further  development  of  such  views, 
and  in  consequence  of  the  great  sympathy  extended  to 
them  everywhere,  a  new  one-sidedness  seized  upon  the 
medicine  of  the  last  century — a  one-sidedness  quite  as 
great  as  the  by-gone  and  partial  idealism  of  the  eighteenth 
century.  This  was  the  thoroly  realistic  method,  which 
gives  to  medicine  the  rank  of  one  of  the  natural  sciences, 
and  finally  goes  so  far  as  to  desire  to  interpret  and  explain 
by  pure  realism  even  the  mental  characteristics. 

Inoculation  was  no  new  thing  when  introduced  during 
the  eighteenth  century.  The  communication  of  natural 
smallpox  to  the  healthy,  in  order  to  protect  them  from 
the  natural  disease,  reaches  back  into  hoary  antiquity. 
The  custom  is  mentioned  among  the  Indians  in  the 
Atharva  Veda.  The  operation  was  always  performed  by 
the  Brahmins,  who  employed  pus  produced  by  those  who 
had  been  inoculated  with  natural  smallpox  one  year 
before,  and  also  the  pus  of  these  secondary  inoculations. 
They  rubbed  the  place  selected  for  operation — in  girls 
the  outside  of  the  arm,  in  boys  the  outside  of  the  forearm 
— with  wool  until  red,  scratched  these  places  several  times 
with  knives  for  a  space  about  an  inch  long,  and  laid  upon 
them  cotton  soaked  in  variolous  pus  and  moistened  with 
water  from  the  Ganges. 

Before  inoculation  a  preparatory  course  of  diet  lasting 
for  four  weeks  was  considered  necessary.  The  inocu-lation 
was  performed  in  the  open  air,  and  the  inoculated  were 
required  to  remain  out  of  bed  to  sprinkle  themselves 
morning  and  evening  with  cold  water.  If  fever  made  its 
appearance  the  sprinkling  was  discontinued  and  the  inocu- 
lated might  at  most  stretch  themselves  before  the  thresh- 
old, and  must  eat  sparingly.  The  Brahmins  traveled 
about  the  country  to  perform  inoculation,  and  the  opera- 
tion was  practiced  in  the  beginning  of  spring.  Under  the 
influence  of  such  excellent  hygienic  regulations  the  results 
were  for  the  most  part  favorable. 

Among  the   Chinese  the   so-called   "pock-sowing"   was 


CONTRIBUTIONS  OF  PRACTITIONERS     235 

practiced  as  early  as  1000  B.C.  by  introducing  into  the 
nasal  cavities  of  children,  aged  three  to  six  years,  a  pled- 
get of  cotton  saturated  with  variolous  pus.  The  Arabians 
had  a  "pox-sale."  Pus  from  a  patient  suffering  with 
small-pox  was  purchased  for  raisins  and  inoculated  with 
needles.  The  Circassians,  too,  by  means  of  needles,  in- 
oculated handsome  girls  upon  the  cheek,  right  wrist,  left 
ankle,  and  over  the  heart,  in  order  to  preserve  their 
beauty. 

In  the  states  of  North  Africa  incisions  were  made  be- 
tween the  thumb  and  index-finger;  among  the  negroes 
inoculation  was  performed  in  the  nose,  and  in  Denmark, 
Scotland,  the  Auvergne  and  other  places,  this  operation 
was  performed  at  an  early  period.  The  employment  of 
the  inoculation  of  natural  smallpox  by  the  Greeks  of 
Constantinople,  where  the  custom  had  been  long  natural- 
ized and  practiced  by  old  women  instructed  in  the  art, 
exercized  a  most  important  influence  upon  the  West. 

But  it  remained  for  Edward  Jenner  to  solve  the  problem. 
He  demonstrated  that  a  simple  attack  of  mild,  never  fatal 
cowpox,  deliberately  acquired,  would  serve  as  a  protection 
against  the  fatal  smallpox.  His  discovery  was  the  result 
of  his  genius  for  original  investigation.  On  the  I4th  of 
May,  1796,  vaccine  matter  was  taken  from  the  hand  of  a 
dairy  maid  and  inserted  into  the  arms  of  a  healthy  boy  of 
eight.  He  went  through  an  attack  of  cowpox  in  regular 
fashion;  then,  two  months  later,  Jenner  inoculated  him 
with  real  smallpox  pus,  but  with  no  deleterious  result. 
In  his  very  complete  and  explicit  report,  he  says : 

"The  deviation  of  man  from  the  state  in  which  he  was 
originally  placed  by  nature  seems  to  have  proved  to  him  a 
prolific  source  of  diseases.  From  the  love  of  splendor, 
from  the  indulgences  of  luxury,  and  from  his  fondness  for 
amusement  he  has  familiarized  himself  with  a  great  num- 
ber of  animals,  which  may  not  originally  have  been  in- 
tended for  his  associates.  The  wolf,  disarmed  of  ferocity, 
is  now  pillowed  in  the  lady's  lap.  The  cat,  the  little  tiger 


236  MEDICINE 

of  our  island,  whose  natural  home  is  the  forest,  is  equally 
domesticated  and  caressed.  The  cow,  the  hog,  the  sheep, 
and  the  horse,  are  all,  for  a  variety  of  purposes,  brought 
under  his  care  and  dominion. 

"There  is  a  disease  to  which  the  horse,  from  his  state 
of  domestication,  is  frequently  subject.  The  farriers  have 
called  it  the  'grease/  It  is  an  inflammation  and  swelling 
in  the  heel,  from  which  issues  matter  possessing  properties 
of  a  very  peculiar  kind,  which  seems  capable  of  generat- 
ing a  disease  in  the  human  body  (after  it  has  undergone 
the  modification  which  I  shall  presently  speak  of),  which 
bears  so  strong  a  resemblance  to  the  smallpox  that  I  think 
it  highly  probable  it  may  be  the  source  of  the  disease. 

"In  this  dairy  country  a  great  number  of  cows  are  kept, 
and  the  office  of  milking  is  performed  indiscriminately  by 
men  and  maid  servants.  One  of  the  former  having  been 
appointed  to  apply  dressings  to  the  heels  of  a  horse 
affected  with  the  'grease/  and  not  paying  due  attention  to 
cleanliness,  incautiously  bears  his  part  in  milking  the 
cows,  with  some  particles  of  the  infectious  matter  adhering 
to  his  fingers.  When  this  is  the  case,  it  commonly  hap- 
pens that  a  disease  is  communicated  to  the  cows,  and  from 
the  cows  to  the  dairymaids,  which  spreads  through  the 
farm  until  the  most  of  the  cattle  and  domestics  feel  its 
unpleasant  consequences.  This  disease  has  obtained  the 
name  of  'cowpox.' 

"Inflamed  spots  now  begin  to  appear  on  different  parts 
of  the  hands  of  the  domestics  employed  in  milking,  and 
sometimes  on  the  wrists,  which  quickly  run  on  to  suppura- 
tion, first  assuming  the  appearance  of  the  small  vesications 
produced  by  a  burn.  Absorption  takes  place,  and  tumors 
(enlarged  lymphatic  glands)  appear  in  each  axilla. 

"The  system  becomes  affected — the  pulse  is  quickened : 
and  shiverings,  succeeded  by  heat,  with  general  lassitude 
and  pains  about  the  loins  and  limbs,  with  vomiting,  come 
on.  The  head  is  painful,  and  the  patient  is  now  and  then 
even  affected  by  delirium.  These  symptoms,  varying  in 


CONTRIBUTIONS  OF  PRACTITIONERS     237 

their  degrees  of  violence,  generally  continue  from  one 
day  to  three  or  four,  leaving  ulcerated  sores  about  the 
hands,  which,  from  the  sensibility  of  the  parts,  are  very 
troublesome,  and  commonly  heal  slowly,  frequently  be- 
coming phagedenic,  like  those  from  whence  they  sprang. 
The  lips,  nostrils,  eyelids,  and  other  parts  of  the  body 
are  sometimes  affected  with  sores;  but  these  evidently 
arise  from  their  being  heedlessly  rubbed  or  scratched  with 
the  patient's  infected  fingers. 

"Thus  the  disease  makes  its  progress  from  the  horse  to 
the  nipple  of  the  cow,  and  from  the  cow  to  the  human 
subject.  Morbid  matter  of  various  kinds,  when  absorbed 
into  the  system,  may  produce  effects  in  some  degree  sim- 
ilar ;  but  what  renders  the  cowpox  virus  so  extremely 
singular  is  that  the  person  who  has  been  thus  affected  is 
forever  after  secure  from  the  infection  of  the  smallpox; 
neither  exposure  to  the  variolous  effluvia,  nor  the  inser- 
tion of  the  matter  into  the  skin,  producing  this  distemper. 

"I  have  often  been  foiled  in  my  endeavors  to  com- 
municate the  cowpox  by  inoculation.  An  inflammation 
will  sometimes  succeed  the  scratch  or  puncture,  and  in  a 
few  days  disappear  without  producing  any  further  effect. 
Sometimes  it  will  even  produce  an  ichorous  fluid,  and  yet 
the  system  will  not  be  affected.  The  same  thing  we  know 
happens  with  the  smallpox  virus. 

"The  very  general  investigation  that  is  now  taking 
place,  chiefly  through  inoculation  (and  I  again  repeat  my 
earnest  hope  that  it  may  be  conducted  with  that  calmness 
and  moderation  which  should  ever  accompany  a  philosoph- 
ical research),  must  soon  place  the  vaccine  disease  in  its 
just  point  of  view.  The  result  of  all  my  trials  with  the 
virus  on  the  human  subject  has  been  uniform.  In  every 
instance  the  patient  who  has  felt  its  influence  has  com-1 
pletely  lost  the  susceptibility  for  the  variolous  contagion ; 
and  as  these  instances  are  now  become  numerous,  I  con- 
ceive that,  joined  to  the  observations  in  the  former  part 
of  this  paper,  they  sufficiently  preclude  me  from  the  neces- 


238  MEDICINE 

sity  of  entering  into  controversies  with  those  who  have 
circulated  reports  adverse  to  my  assertions,  on  no  other 
evidence  than  what  has  been  casually  collected." 

It  was  not  long  before  the  opposition  to  the  practice  of 
vaccination  took  definite  form,  and  it  has  continued  down 
to  this  very  day.  It  is  opposed,  however,  only  by  those 
who  will  not  seek  statistics,  which  readily  prove  the  enor- 
mous benefit  that  Edward  Jenner  conferred  on  humanity. 
Smallpox  in  epidemic  form  is  unknown  where  vaccination 
is  compulsory. 

Another  great  advance  in  the  prevention  of  human 
suffering  was  begun  by  Philippe  Pinel  in  1792.  While  in 
charge  of  the  Bicetre  Hopital  he  removed  chains  from 
the  insane  patients,  and  instituted  a  rational  and  humane 
treatment,  such  as  is  adopted  to-day. 

Throughout  the  eighteenth  century  an  incredible  num- 
ber of  strange  and  useless  remedies  were  regarded  as 
efficacious,  such  as  mummy,  millepeds,  wood-lice ;  and  even 
amulets  were  found  in  shops.  Instead  of  simplifying  the 
materia  medica,  a  great  many  new  drugs  were  added. 
Three  remedies — or  rather  three  therapeutic  methods — re- 
quire to  be  more  carefully  considered,  since  two  of  them 
during  the  eighteenth  century  began  to  be  methodically 
and  generally  employed  and  scientifically  studied,  and  the 
third  was  revived  in  a  new  form. 

It  has  already  been  stated  that  the  ancients,  from  the 
days  of  the  Asclepiadse,  employed  the  waters  of  healing 
springs,  mineral  waters,  often  too  frequently — Archi- 
genes  had  the  patient  drink  as  much  as  fifteen  pints  for 
the  relief  of  stone.  Indeed  waters  were  even  classified 
according  to  their  constituents  as  alum-waters,  sulphur- 
waters,  chalybeate  waters,  bituminous  waters,  etc.  The 
Italian  physicians  of  the  last  half  of  the  Middle  Ages 
prescribed  these  waters.  At  a  later  period  mineral  waters 
were  drunk  still  more  frequently,  indeed  in  considerable 
quantities,  for  at  that  time,  even  more  than  to-day,  the 
excellence  and  efficacy  of  the  water  was  judged  by  its 


CONTRIBUTIONS  OF  PRACTITIONERS     239 

strength,  particularly  its  cathartic  effects.  Paracelsus 
exercized  a  great  influence  upon  the  theory  and  employ- 
ment of  mineral  springs  (particularly  those  of  Pfeffers, 
Gastein,  etc.),  and  it  is  one  of  his  chief  services  that  he 
subjected  the  learned  medicine  of  his  day  (which  thought 
itself  safe  only  in  guilds  and  study-rooms)  to  the  test  of 
living  observation  and  actual  life,  and  employed  chemistry 
in  medicine,  particularly  also  as  it  related  to  the  question 
of  mineral  springs.  As  the  science  of  chemistry  itself 
was  improved,  the  subject  of  mineral  waters  likewise 
enjoyed  increasing  attention. 

The  use  of  ordinary  water  as  a  remedial  drink  and  in 
the  form  of  (cold  and  tepid)  lavations  and  baths  for  the 
cure  of  diseases,  especially  those  of  a  febrile  character, 
first  made  its  way  into  German  practice  in  the  eighteenth 
century,  tho  it  had  been  in  use  among  other  nations  at  an 
earlier  period. 

Even  Hippocrates  permitted  baths  in  febrile  diseases, 
tho  rather  tepid  baths  than  cold.  He  was  particularly 
fond  of  these  in  pneumonia,  to  mitigate  the  pain  and 
facilitate  expectoration  and  respiration.  It  is  remembered 
that  Musa  cured  the  Emperor  Augustus  by  means  of  cold 
baths,  after  warm  baths  had  failed  to  produce  any  benefit. 
Asclepiades,  Charmis  of  Marseilles,  Agathinus,  Herodotus, 
Celsus,  Aretaeus,  Aetius  and  others  likewise  employed  cold 
water,  most  frequently  in  the  form  of  affusions  in  the  case 
of  epileptics  and  lethargic  patients,  and  as  lavations  and 
cold  dressings  upon  the  head  in  typhus.  Galen,  like  Hippo- 
crates, was  no  great  friend  of  cold  lavations  and  baths, 
tho  he  employed  the  former  in  the  fevers  of  young 
people,  excluding  hectic  fever.  Among  the  Arabians, 
Rhazes  recommended  cold  lavation  and  dipping  in  cold 
water  in  cases  of  smallpox  and  measles.  Avicenna  fol- 
lowed Galen,  and  regulated  his  employment  of  cold  in 
accordance  with  the  age,  constitution  and  season  of  the 
year.  The  American  Indians  also  practiced  hydrotherapy 
in  the  treatment  of  yellow  fever. 


240  MEDICINE 

The  epidemics  of  the  eighteenth  century,  while  not  so 
severe  as  those  of  the  preceding  centuries,  were  frequent 
and  extensive  enough  to  create  new  problems  for  investi- 
gation and  treatment.  Plague  was  still  seen  in  northern 
Europe;  typhus  fever  was  prevalent  mostly  after  the 
wars;  typhoid  fever  was  first  described  in  this  century; 
malaria  gave  rise  to  great  epidemics;  dysentery,  ergotism 
and  diphtheria  were  very  common.  Diphtheria  was  par- 
ticularly prevalent  and  deadly.  Smallpox  has  diffused  gen- 
erally over  all  the  world.  In  1770,  smallpox  carried  off 
3,000,000  in  the  East  Indies.  Yellow  fever  was  mostly 
confined  to  America.  Hospitals  during  the  whole  eight- 
eenth century  were  undesirably  managed.  "Hospital 
fever"  never  left  them,  as  there  was  no  hospital  hygiene. 
Many  hospitals  contained  large  beds,  occupied  often  by 
from  four  to  six  patients,  and  the  mortality  was  rarely  less 
than  20  per  cent.  Almost  all  who  underwent  operations, 
especially  amputations,  died.  However,  with  the  introduc- 
tion of  clinical  instruction  for  students,  conditions  became 
improved. 

The  physician  of  the  eighteenth  century  was  even  in 
externals  distinct  professionally,  at  least  on  festive  oc- 
casions, from  other  men,  and  was  distinguished,  as  are 
many  modern  "precise  followers"  of  ^Esculapius,  by  the 
fashionable  cut  of  his  clothing,  his  universal  greetings, 
rapid  gait,  and  amiability.  Usually  a  thermometer,  stetho- 
scope, or  percussion-hammer  is  described  as  peeping  out 
of  his  pockets.  The  English  physician  had  become  a 
man  of  standing  and  took  his  rank  with  the  parson  and 
the  squire. 


CHAPTER  IX 

NINETEENTH-CENTURY    THEORIES 

THE  beginning  of  the  nineteenth  century  marks  one  of 
the  most  important  movements  in  the  history  of  all 
sciences,  especially  medicine.  There  was  a  great  upheaval 
in  all  things,  intellectual  and  otherwise,  due  mostly  to  the 
terrible  revolution  in  France.  After  the  peace,  scientific 
study  of  all  the  branches  began  to  assume  wonderful  pro- 
portions, especially  in  chemistry,  histology,  pathology  and 
clinical  instruction.  The  physicians  and  scientists  of  other 
countries  flocked  to  Paris  and  there  learned  the  new 
method  of  investigation  and  research — that  is,  experi- 
mentation. These  new  ideas  and  methods  were  carried 
to  other  countries  and  stimulated  the  development  of 
science. 

The  eighteenth  century  regarded  as  its  chief  task,  the 
rescue  of  the  people  from  the  medieval  restrictions  and 
limitations,  particularly  the  spiritual  side  of  life.  On  the 
other  hand,  the  nineteenth  century  struggled  almost 
extravagantly  for  the  accomplishment  of  the  economical 
or  material  demands  for  existence.  This  was  seen  in  the 
many  revolutions  and  wars  for  that  purpose,  abolishing 
slavery  and  placing  in  the  foreground  the  individual, 
exposing  him  to  the  test  of  freedom. 

Over  the  medicine  of  the  present  day  the  natural 
sciences  have  attained  a  control  which  is  even  more  abso- 
lute than  that  seen  in  the  seventeenth  century.  Buckle 
says  regarding  the  cultivation  of  the  natural  sciences :  "It 

241 


242  MEDICINE 

cannot,  however,  be  concealed  that  we  manifest  an  inor- 
dinate respect  for  experiments,  an  undue  love  of  minute 
detail  and  a  disposition  to  over-estimate  the  inventors  of 
new  instruments  and  the  discoverers  of  new  but  often 
insignificant  facts."  In  another  place  he  says,  "In  vain  do 
we  demand  that  the  details  be  more  generalized,  and  re- 
duced into  order.  We  want  ideas,  and  we  get  more  facts. 
We  hear  constantly  of  what  Nature  is  doing,  but  we  rarely 
hear  of  what  man  is  thinking.  We  are  in  the  predicament 
that  our  facts  have  outstripped  our  knowledge  and  are 
now  encumbering  its  march." 

The  theory  of  excitement  was  a  modification  of  Bruno- 
nianism  and  was  one  of  solidism.  According  to  this  theory, 
life  depends  upon  irritability,  which  is  inherent  in  the 
organism  as  an  independent  capacity.  Thus  two  things, 
irritability  and  organization,  are  taken  into  consideration, 
while  Brown  recognised  only  the  former.  The  grade  of 
irritability  determines  the  condition  and  behavior  of  the 
body,  and  health  consists  in  moderate  irritation  and 
moderate  excitability.  Another  offshoot  of  the  Brunonian 
theory,  far  worse,  was  the  "New  Italian  Theory."  Its 
author  was  Rasori,  of  Milan.  Its  bad  effects  were  the 
more  evident  and  deplorable  because  when  applied  to  the 
treatment  of  diseases,  humanity  must  needs  suffer.  He 
taught  that  the  diagnosis  of  diseases  cannot  be  made  from 
the  symptoms,  but  solely  from  the  remedies  which  benefit 
them  or  make  them  worse.  Venesection  is  regarded  as  the 
most  reliable  diagnostic  means.  If  it  be  beneficial,  a  cer- 
tain condition  exists  which  calls  for  certain  medicines. 
If,  after  twice  performing  venesection,  there  is  no  benefit, 
the  disease  must  be  treated  on  other  lines.  Enormous 
doses  of  medicine  were  given,  often  interfering  to  an 
alarming  extent  with  the  process  of  healing. 

In  direct  opposition  to  this  system  of  medicine  was 
early  homeopathy.  The  action  of  drugs  on  healthy  per- 
sons becomes  the  guide  for  a  selection  of  remedies  with 
which  to  treat  disease.  Accordingly,  for  the  removal  of  a 


NINETEENTH-CENTURY  THEORIES        243 

given  group  of  symptoms,  that  remedy  must  be  selected 
which  when  given  to  a  healthy  person  has  produced  the 
same,  or  at  least  a  similar,  group  of  symptoms.  The 
homeopathic  physician  thus  is  required  to  know  thoroly 
and  accurately  the  effect  of  every  drug  on  the  human  sys- 
tem ;  must  know  every  symptom  group,  so  as  to  apply  the 
correct  remedies,  working  thus  on  the  theory  "similia 
similibus  curantur,"  and  thus  works  with  a  complete 
knowledge  of  what  he  is  doing.  Samuel  Hahnemann 
(1755-1843),  of  Meissen,  was  the  founder  of  this  school. 
By  long  study  he  came  to  the  conclusion  that  all  diseases 
were  general,  none  local.  He  discovered  four  hundred  and 
twelve  symptoms  of  the  "psora,"  or  itch,  which  had  its 
chief  symptoms  in  the  skin,  and  occasioned  "so  many 
secondary  symptoms,  that  at  least  seven-eighths  of  all 
chronic  complaints  arose  from  this  single  source."  He 
claims  that  lycopodium  in  extremely  minute  doses  sets  up 
a  wonderful  group  of  symptoms — falling  of  the  hair,  con- 
fusion of  thought,  eruptions,  etc.  In  therapeutics,  there 
are  specifics  only,  and  their  efficacy  is  added  to  by 
dilution. 

A  single  dose  of  a  properly  chosen  specific  frequently 
cures  immediately.  In  the  administration  of  homeopathic 
medicine  the  strictest  diet  must  always  be  maintained.  An 
offshoot  of  this  early  school  of  homeopathy  was  a  doctrine 
called  Isopathy.  According  to  this,  like  was  to  be  cured 
by  like,  no  matter  how  nauseous  or  abhorrent  to  the  taste. 
It  occasioned  attacks  on  its  parent  system  and  lived  only 
a  short  life.  Modern  Homeopathy,  however,  has  developed 
to  no  inconsiderable  magnitude,  and  possesses  many  fol- 
lowers to-day  whose  reputation  is  often  not  less  than  the 
allopath.  But  even  more  important  is  the  beneficial  effect 
Hahnemann's  work  had  in  modifying  the  giving  of  large 
doses  of  potent  drugs. 

Franqois  Broussais  (1772-1838)  advanced  a  theory 
which  he  called  Physiological  Medicine.  According  to 
him,  life  depends  upon  external  irritation,  especially  that 


244  MEDICINE 

of  heat.  The  latter  sets  up  in  the  body  peculiar  chemical 
reactions,  which  maintain  regeneration  and  assimilation, 
as  well  as  contractility  and  sensibility.  When  these  func- 
tions, which  are  supported  by  heat,  cease,  death  comes  on 
at  once.  Health  depends  upon  the  moderate  action  of  the 
-external  irritants ;  disease  upon  their  weakness  or  on  their 
exceptional  strength.  Diseases  originate  from  local  irrita- 
tions, proceeding  from  a  certain  diseased  organ,  or  part  of 
an  organ,  particularly  from  the  heart,  and  often  from  the 
mucous  membrane  of  the  stomach  and  intestines,  and  these 
irritations  diffuse  themselves  throughout  the  rest  of  the 
body  through  sympathy  and  by  way  of  the  nervous  system. 
Every  irritation  which  through  sympathetic  irritation  of 
the  heart  produces  fever,  has  become  an  inflammation,  and 
the  judge  of  this  is  hyperemia.  The  famous  "gastro- 
enteritis" is  the  most  usual  result  of  irritations  of  the 
brain.  Through  complications,  it  causes  typhus  and  all 
other  so-called  infectious  diseases.  He  denied  the  exist- 
ence of  specific  morbid  poisons.  This  "gastroenteritis"  or 
'"basis  of  pathology,"  he  divided  into  two  classes:  If 
gastroenteritis  predominates,  it  is  accompanied  with  pains 
in  the  gastric  region,  and  sudden  vomiting  of  food  and 
drink.  If,  however,  the  enteritis  (not  the  stomach,  but 
the  intestine)  is  the  chief  lesion,  great  thirst,  a  sensation 
of  internal  heat,  a  sensitive  abdomen,  a  rapid  hard  pulse, 
and  a  coated  tongue  are  the  chief  phenomena. 

In  therapeutics  Broussais  believed  that  the  physician  is 
the  lord  of  Nature.  He  must  anticipate  disease,  particu- 
larly the  gastroenteritis,  against  which  all  his  efforts  must 
t>e  exerted.  For  this  purpose,  the  antiphlogistic  or  weak- 
ening method  is  best.  Febrile  and  inflammatory  diseases 
he  treated  by  the  withdrawal  of  nourishment,  carried  to 
the  extreme.  He  preferred,  as  the  most  efficient,  anti- 
phlogistic treatment,  in  place  of  venesection,  which  he 
strongly  approves  of,  the  employment  of  leeches,  applying 
them  to  the  gastric  region.  In  robust  individuals,  thirty 
to  fifty  might  be  applied  at  once.  In  rheumatism  and  gout, 


NINETEENTH-CENTURY  THEORIES        245 

they  were  applied  to  the  joints,  and  to  the  pit  of  the 
stomach. 

The  French  School  of  Pathological  Anatomy  helped  to 
advance  medicine.  It  taught  that  pathology  was  patho- 
logical anatomy,  while  aiming  to  elevate  the  latter  science 
into  a  "clinical  anatomy,"  requiring  the  physician  to  search 
his  patient  for  the  changes  of  pathological  anatomy.  It 
required  him  to  remove  the  products  of  the  disease,  rather 
than  try  to  cure  or  remove  the  cause  of  the  disease.  The 
living  patient  became  a  mere  subject  for  diagnosis  and 
local  therapeutic  investigation.  Many  diseases  were 
therefore  considered  incurable,  and  the  desire  and  ability 
to  cure  disease  were  weakened. 

Functional  or  dynamic  disturbances  were  disregarded, 
while  diseases  of  the  fluids  of  the  body  were  at  first  almost 
entirely  forgotten,  these  errors  being  due  to  the  fact  that 
on  autopsy  no  lesions  were  discovered.  The  patient  was 
treated  rather  as  a  living  cadaver,  not  as  a  being  endowed 
with  vital  forces.  But  if  the  practice  of  medicine  lost  by 
these  methods,  on  the  other  hand,  knowledge  of  the 
changes  produced  in  the  body  by  disease  was  greatly 
increased. 

The  School  of  Natural  Philosophy  was  founded  in  Ger- 
many. It  was  a  purely  speculative  system,  full  of  scholas- 
tic phrases.  The  school  brought  forth  mainly  a  philosophy 
of  medicine,  rather  than  philosophical  medicine.  The 
School  of  Natural  History  followed.  Baas  claims  that 
this  was  the  expression  of  the  turn  which  medicine  was 
compelled  to  take  to  escape  from  the  after-effects  of  the 
one-sided,  ideal  or  systematizing  tendency  of  the  eight- 
eenth century  (of  which  natural  philosophy  was  the  final 
product),  and  10  enter  upon  the  realistic  or  positive  tend- 
ency of  science  and  culture  in  the  nineteenth  century  in 
both  medicine  and  the  other  sciences.  It  shows  everywhere 
its  mediatorial  position  between  the  old  traditions  and 
the  most  recent  times.  Thus,  for  the  purpose  of  careful 
observation,  it  fostered,  indeed,  the  ancient  Hippocratic 


246  MEDICINE 

diagnosis  and  method,  by  which  it  preserved  its  connection 
with  the  earlier  medicine,  and  which  the  later  school  of 
natural  science  almost  entirely  set  aside.  In  addition,  how- 
ever, it  cultivated  considerably  the  physical,  and  par- 
ticularly the  microscopic,  diagnosis  adopted  from  France. 
Indeed  this  school  gave  a  decisive  impulse  to  microscopic 
investigation  in  general,  so  that  Virchow,  one  of  its  scions, 
subsequently  founded  upon  it  his  cellular  pathology,  and 
thus  elevated  the  microscope  to  the  fundamental  instru- 
ment in  pathology  and  pathological  anatomy. 

The  attempt  was  made  by  this  school  to  classify  diseases 
"naturally,"  into  classes,  families,  species  or  kinds,  such 
as  in  botany.  There  were  some  physicians  in  this  school 
who  later  considered  diseases  to  be  genuine  second  organ- 
isms in  the  diseased  body. 

The  new  Vienna  school  was  a  continuation  of  the  patho- 
logico-anatomical  school  of  Paris,  greatly  elaborated  upon 
and  added  to.  The  leaders  of  the  school  had  at  their  dis- 
posal over  a  thousand  bodies  annually  to  dissect,  so  that, 
as  a  matter  of  course,  pathological  anatomy  was  utilized 
from  the  standpoint  of  statistics.  The  microscope  and 
chemistry  were  added  for  further  study.  Later  the  intro- 
duction of  the  laws  of  sound  into  the  interpretation  and 
conception  of  physico-diagnostic  phenomena  was  made  by 
Joseph  Skoda.  Skoda,  by  his  views  on  physical  diagnosis, 
showed  himself  an  independent  spirit  who  got  his  impulse 
from  France,  but  far  outstripped  the  French  diagnosti- 
cians. On  the  other  hand,  practical  medicine  in  his  hands 
degenerated  again  into  simple  diagnosis.  Not  long  after 
this  physiology  was  utilized  to  explain  Dathology. 

Henle  defines  the  duty  of  the  physician  to  be  the  pre- 
vention and  cure  of  diseases.  Here  two  methods  of  pro- 
ceeding are  to  be  distinguished,  the  empirical  and  the 
rational  (theoretic,  physiological).  The  latter  is  likewise 
the  method  of  physiology;  it  is  the  method  of  all  experi- 
mental sciences  and  particularly  of  the  natural  sciences. 
Moreover,  the  genuine  scientific  spirit  is  said  to  consist  not 


NINETEENTH-CENTURY  THEORIES        247 

in  ignoring  or  scorning  philosophy,  but  "in  the  conscious 
and  provisional  renunciation  of  the  knowledge  of  the  first 
cause  of  things,  because  the  time  of  proof  is  not  yet  past/' 
"Accordingly  if  the  collection  of  experiences  is  the  chief 
thing,  yet  hypotheses  must  form  a  balance  to  its  instabil- 
ity." 

"In  experimenting  we  fix  arbitrarily  the  cause,  so  far  as 
possible,  and  by  observing  the  results  we  assure  ourselves 
of  the  correctness  of  our  conclusions.  In  this  process  the 
so-called  localization  of  symptoms — that  is,  the  search  for 
the  organ  from  which  the  symptoms  proceed — is  aimed  at, 
but  in  addition,  too,  a  knowledge  of  the  quality  of  patho- 
logical changes,  by  a  comparison  of  the  altered  form  and 
composition  with  the  normal.  Pathology  owes  its  weighti- 
est facts  to  the  employment  of  the  microscope  and  to  or- 
ganic chemistry."  Moreover,  the  hypothesis  of  a  vital 
force  is  admissible  and  is  just  as  good  or  as  weak  as  that 
of  electric  attraction  or  of  gravitation. 

Disease  is  "a  deviation  from  the  normal,  typical — i.e., 
healthy — process  of  life,  a  modification  of  health,  a  re- 
moval from  the  relative  norm.  The  essence  of  disease, 
however,  is  an  expression  of  typical  force  under  unwonted 
conditions."  Disease,  too,  like  life  itself,  is  a  process. 
Diseases  are  anomalies  of  this  process.  Any  alteration 
which  completely  abolishes  this  process  occasions  not  dis- 
ease but  death.  Death  is  the  cessation  of  the  interchange 
of  material.  The  termination  in  health  follows  spontane- 
ously or  through  artificial  or  accidental  influences.  The 
transition  to  health  ensues  gradually  in  most  chronic  and 
in  many  acute  diseases;  in  others,  especially  in  acute  dis- 
eases, the  symptoms  disappear  suddenly.  The  first  and 
slower  method  is  called  lysis,  the  last  method  crisis — the 
latter  term  a  relic  handed  down  from  the  mythical  be- 
ginnings of  medicine.  A  critical  secretion  is,  in  the  main, 
nothing  more  than  a  secretion  belonging  to  the  stadium  of 
the  crisis.  "The  belief  in  crises,  according  to  Henle, 
stands  upon  the  same  footing  as  belief  in  the  devil.  That 


248  MEDICINE 

the  exorcist  had  expelled  a  devil  was  demonstrated  by  the 
foul  odor  left  behind  by  the  evil  spirit.  The  odor  was  a 
fact;  that  it  could  be  diffused  in  no  way  except  by  the 
devil  was  perfectly  self-evident."  The  same  was  the  case 
with  critical  perspiration  and  such  matters. 

The  modern  chemical  system,  in  opposition  to  the  chemi- 
cal system  of  the  eighteenth  century  which  was  founded 
on  inorganic  chemistry,  was  the  result  of  the  active  re- 
searches and  discoveries  in  organic  chemistry,  and  upon  it 
the  present  theory  of  metabolism  is  based.  According  to 
this  theory  the  physical  changes  in  the  body,  so  far  as  they 
cannot  be  classified  as  mechanical  processes,  are  nothing 
more  than  oxidation  or  combustion  of  the  elements  of  the 
body,  effected  by  the  oxygen  in  the  blood,  from  inspired 
air;  the  body  is  a  living  retort  or  test-tube.  The  parts  of 
the  body  were  supposed  to  be  destroyed  and  then  regen- 
erated. This  process  of  oxidation  is  twofold,  depending 
upon  the  two  great  classes  of  food-stuffs  which  compose 
the  body  or  are  taken  into  it.  The  respiratory  foods 
(hydrocarbons,  fats)  are  burned  in  the  lungs  during 
respiration  and  chiefly  excreted  there  as  carbonic  acid. 
The  so-called  nutritive  materials  (nitrogenous,  blood- 
forming  foods),  which  compose  the  tissues  proper,  are 
consumed  in  the  tissues  themselves  and  are  discharged  as 
urea  in  the  renal  secretion. 

Animal  heat,  they  claimed,  was  the  result  of  the  proc- 
esses of  oxidation  going  on  constantly  within  the  body. 
The  one  class  of  foods,  albuminous  or  nitrogenous,  serves 
for  the  formation  of  the  blood  and  construction  of  the 
large  parts  of  the  body,  the  other  class  is  similar  to  ordi- 
nary fuel  and  serves  mainly  for  the  production  of  heat. 

Fever  was  regarded  as  an  abnormal  increase  in  the 
process  of  combustion,  disease  a  defect  in  this  process. 
If  one  group  of  these  materials  is  missing,  therapeutic 
measures  are  indicated  to  increase  the  food  of  this  sort 
and  thus  supply  the  deficiency.  The  theory  regards  the 
living  body  from  the  viewpoint  of  a  chemist,  to  the  chemi- 


NINETEENTH-CENTURY  THEORIES        249 

cal  laboratory  and  chemical  analysis,  and  does  not  pay 
sufficient  attention  to  the  adaptable  side  of  physical  life 
nor  to  the  ever-changing  and  powerful  influences  in  which 
the  body  is  always  placed.  Yet  the  theory  was  of  great 
importance  in  that  it  placed  dietetics  once  more  in  the 
foreground. 

Modern  cellular  vitalism  was  the  result  of  the  researches 
of  Rudolph  Virchow,  born  1821.  Then  later,  through  the 
works  of  Beale,  Louis  Agassiz,  Sharpey,  Hassall,  Bastian, 
Tyndal,  Huxley  and  others,  every  organized  structure  of 
the  living  body  was  subjected  to  microscopic  analyses  and 
found  to  be  composed  of  individual  cells,  varying  in  size 
and  shape,  and  performing  a  great  variety  of  functions, 
but  all  composed  essentially  of  an  organizable  substance 
recognised  as  the  physical  basis  of  life  and  called  by  some 
investigators  protoplasm  and  by  others  bioplasm.  Its  most 
distinctive  attribute  is  its  vital  capacity  to  grow  and  mul- 
tiply or  propagate  itself.  Thus  they  found  all  living  bodies, 
both  animal  and  vegetable,  composed  of  protoplasm  aggre- 
gated in  minute  forms  called  cells  and  united  in  various 
ways  to  constitute  all  the  organized  matter  in  the  fluids 
and  solids  of  living  bodies. 

The  theory  is  merely  a  modified  employment  of  the  old 
idea  of  the  "vital  force,"  referring  the  latter  to  the  con- 
crete, minutest  parts,  the  so-called  "corporeal"  elements. 
"Every  animal  appears  as  a  sum  of  vital  unities,"  this 
school  declared,  "each  of  which  bears  all  the  characteris- 
tics of  life.  The  characteristics  and  unity  of  life  cannot 
be  found  in  any  determinate  point  of  a  higher  organization  , 
— e.g.,  in  the  brain  of  man — but  only  in  the  definite,  ever- 
recurring  arrangement  which  each  element  presents. 
Hence  it  results  that  the  composition  of  a  large  body 
amounts  to  a  kind  of  social  arrangement,  an  arrangement 
of  a  social  kind  in  which  each  of  a  mass  of  individual  ex- 
istences is  dependent  upon  the  others,  but  in  such  a  way 
that  each  element  has  a  special  activity  of  its  own,  and 
that  each,  altho  it  receives  the  impulse  to  its  own  activ- 


250  MEDICINE 

ity  from  other  parts,  still  itself  performs  its  own  func- 
tions." 

The  cell  is  thus  the  actual,  ultimate,  proper  morphologi- 
cal element  of  every  vital  manifestation — "omnis  cellula  e 
cellula" — and  the  action  takes  place  within  the  cell  itself. 
The  most  constant  part  of  the  cell  is  the  nucleus  or  central 
spot  of  the  cell.  Next  to  the  cell  is  the  membrane.  The 
development  or  increase  of  cells  is  continuous;  it  takes 
place  by  continual  growth  of  cells,  and  a  new  growth  of 
cells  presupposes  existing  cells. 

The  reception  of  nutritive  materials  is  effected  through 
the  activity  of  the  tissue  elements  in  the  form  of  an  attrac- 
tion of  this  material  by  the  tissues  themselves  in  proportion 
to  their  needs.  Virchow  taught  that  certain  tissue  ele- 
ments have  the  power  to  extract  certain  materials,  thus 
possessing  specific  affinity;  thus  the  liver  extracts  sugar 
and  bile  from  the  blood.  He  also  held  that  the  vascular 
system  was  completely  closed  by  membranes. 

In  the  doctrine  of  inflammation  Virchow,  in  addition 
to  the  four  well-known  phenomena  of  inflammation — 
redness,  heat,  swelling,  pain — took  up  the  disturbance  of 
the  function  of  the  diseased  part.  In  fact,  he  laid  most 
stress  on  this  as  the  most  effective  symptom. 

Many  important  points  of  the  vitalistic  cellular  theory 
have  already  been  disproven  in  the  light  of  more  recent 
microscopic  interpretations.  It  is  the  one  great  theory  on 
which  its  author  did  not  try  to  build  a  system  of  therapeu- 
tics. One  of  the  results  of  this  theory  was  the  formation 
of  the  school  of  natural  sciences,  which  seeks  chiefly  by 
the  aid  of  pathological  anatomy  and  microscopy  to  render 
medicine  an  "exact"  science.  The  hygiene  school  also  ad- 
vanced to  the  front.  The  tendency  of  this  latter  school 
was  to  split  up  medicine  into  specialties  and  increase  the 
number  of  subordinate  branches. 


CHAPTER  X 

MODERN  TREATMENT  OF  DISEASE 

THE  Modern  Parasitic,  or  Germ  Theory,  had  its  origin 
shortly  after  the  invention  of  the  microscope,  when  a  for- 
mer school  maintained  that  diseases  were  due  to  micro- 
scopic organisms  and  animals.  In  the  present  day,  how- 
ever, the  lowest  order  of  plants  is  believed  to  be  the 
infecting  material  in  certain  infectious  diseases.  Haller, 
some  years  ago,  injected  putrid  matter  into  the  veins  of  an 
animal  and  caused  pyemia  and  then  became  the  creator 
of  experimental  pathology.  Parasites  were  discovered 
causing  diseases  in  animals  and  plants ;  in  skin  and  scalp 
diseases  the  modern  theory  of  the  production  of  diseases 
through  infection  found  further  support  in  the  investiga- 
tions relative  to  the  processes  of  fermentation  and  putre- 
faction, with  which  the  processes  of  disease  were  at  once 
compared. 

Pasteur  demonstrated  that  fermentation  and  putrefaction 
were  caused  not  by  chemical  ferments,  as  Liebig  thought, 
but  were  merely  the  vital  processes  of  lower  organisms. 
These  he  divided  into  two  great  classes — aerobes,  which 
work  only  in  the  presence  of  oxygen,  and  anaerobes,  which 
work  without  oxygen  but  do  not  survive  after  action. 
Wound  infections  were  for  the  first  time  considered  in- 
fected from  the  outside.  Robert  Koch  demonstrated  the 
development  of  bacteria  from  spores.  At  the  present  day 
no  consistent  theory  exists  which  fully  explains  parasitic 
action  in  disease.  Certain  of  the  lower  fungi,  as  parasites 

251 


252  MEDICINE 

within  or  upon  the  body,  cause  diseases  of  the  infectious 
type.  There  are  two  theories  concerning  the  modus  oper- 
andi  of  these  parasites.  One  is  that  by  the  development 
and  growth  of  these  germs  in  the  system  the  body  is  de- 
prived of  its  nutriment  and  life  endangered  by  the  lack  of 
oxygen.  According  to  the  other  theory,  these  parasites 
give  off  in  their  own  metabolism  poisonous  products  (tox- 
ines),  which  interfere  with  the  action  of  normal  cells. 

Elie  Metchnikoff,  of  Odessa,  observed  that  the  wan- 
dering cells — the  white  blood  corpuscles — after  the  manner 
of  amoebae,  surround  and  attack  and  then  devour  ("phago- 
cyte") the  germs  which  enter  the  body,  thus  rendering 
them  harmless.  He  considered  inoculation  as  a  sort  of 
preliminary  training  of  these  wandering  white  cells,  so 
that  if  the  disease  against  which  the  patient  had  been 
inoculated  should  befall  him  the  "phagocytes"  would  be 
prepared  and  the  more  readily  destroy  the  offending  bac- 
teria. When  a  person  dies  of  an  infectious  disease,  he  ex- 
plains it  by  claiming  that  the  number  of  bacteria  was  too 
large  for  the  wandering  cells  to  overcome  and  devour. 
His  theory  has  many  opponents,  who  declare  that  dis- 
eases are  cured  by  the  cessation  of  the  process  of  develop- 
ment of  the  bacteria  in  consequence  of  their  death. 

The  practical  medicine  of  the  modern  age  has  gained 
many  important  and  permanent  advantages  through  the 
improvements  in  diagnosis  of  the  phenomena  and  pictures 
of  disease.  These  aids  to  practical  knowledge  are  derived 
from  the  natural  sciences,  which  have  been  so  wonderfully 
developed  in  modern  days.  The  physical  diagnosis  of  the 
present  time  took  its  origin  in  the  eighteenth  century,  when 
Auenbrugger  announced  his  method  of  percussion.  Not 
long  after  that  Rene  Laennec  presented  his  method  of 
auscultation,  a  method  of  listening  to  the  sounds  produced 
in  the  chest  when  air  is  inspired  and  expired  in  health  and 
disease,  and  also  to  the  sound  produced  by  the  heart  and 
its  valves  in  health  and  disease.  It  was  quite  by  accident 
that  he  came  upon  his  great  invention. 


MODERN  TREATMENT  OF  DISEASE       253 

He  says :  "I  was  consulted  by  a  young  person  who  was 
laboring  under  the  general  symptoms  of  a  diseased  heart. 
In  her  case  percussion  and  the  application  of  the  hand 
(what  modern  doctors  call  palpation)  were  of  little  service 
because  of  a  considerable  degree  of  stoutness.  The  other 
method,  that  namely  of  listening  to  the  sound  within  the 
chest  by  the  direct  application  of  the  ear  to  the  chest  wall, 
being  rendered  inadmissible  by  the  age  and  sex  of  the 
patient,  I  happened  to  recollect  a  simple  and  well-known 
fact  in  acoustics  and  fancied  it  might  be  turned  to  some 
use  on  the  present  occasion.  The  fact  I  allude  to  is  the 
great  distinctness  with  which  we  hear  the  scratch  of  a  pin 
at  one  end  of  a  piece  of  wood  on  applying  our  ear  to  the 
other. 

"Immediately  on  the  occurrence  of  this  idea  I  rolled  a 
quire  of  paper  into  a  kind  of  cylinder  and  applied  one  end 
of  it  to  the  region  of  the  heart  and  the  other  to  my  ear.  I 
was  not  a  little  surprised  and  pleased  to  find  that  I  could 
thereby  perceive  the  action  of  the  heart  in  a  manner  much 
more  clear  and  distinct  than  I  had  ever  been  able  to  do  by 
the  immediate  application  of  the  ear. 

"From  this  moment  I  imagined  that  the  circumstance 
might  furnish  means  for  enabling  us  to  ascertain  the  char- 
acter not  only  of  the  action  of  the  heart,  but  of  every  spe- 
cies of  sound  produced  by  the  motion  of  all  the  thoracic 
viscera,  and  consequently  for  the  exploration  of  the 
respiration,  the  voice,  the  rales  and  perhaps  even  the 
fluctuation  of  fluid  effused  in  the  pleura  or  pericardium. 
With  this  conviction  I  forthwith  commenced  at  the  Necker 
Hospital  a  series  of  observations  from  which  I  have  been 
able  to  deduce  a  set  of  new  signs  of  the  diseases  of  the 
chest.  These  are  for  the  most  part  certain,  simple  and 
prominent,  and  calculated  perhaps  to  render  the  diagnosis 
of  the  diseases  of  the  lungs,  heart  and  pleura  as  decided 
and  circumstantial  as  the  indications  furnished  to  the  sur- 
geons by  the  finger  or  sound  in  the  complaints  wherein 
these  are  of  use." 


254  MEDICINE 

He  worked  out  the  practical  and  mechanical  aspect, 
making  a  stethoscope  about  ten  inches  long  with  a  diame- 
ter of  four  inches,  and  contained  in  its  lower  end  an 
obturator,  upon  which  he  laid  great  stress.  Laennec's  inter- 
pretation of  the  sounds  heard  was  based  upon  perfectly 
definite  morbid  conditions  existing  in  the  thoracic  viscera, 
while  Skoda  formed  his  physical  rules  upon  the  basis  of 
the  principles  of  acoustics.  Piorry  improved  the  stetho- 
scope and  invented  the  pleximeter,  an  instrument  used  for 
the  aid  of  mediate  percussion.  The  percussion  hammer 
was  next  invented,  designed  to  take  the  place  of  the  fingers 
for  tapping. 

One  of  the  greatest  inventions  of  all  ages  is  that  of  the 
ophthalmoscope  by  Helmholtz.  By  means  of  this  instru- 
ment the  oculist  can  inspect  the  interior  of  the  eye  and 
easily  decide  whether  it  is  in  healthy  or  diseased  condi- 
tion. The  laryngoscope  is  second  in  importance  only  to 
the  ophthalmoscope.  A  few  of  the  other  diagnostic  instru- 
ments that  have  since  been  in  use  are  the  aural  and  nasal 
specula,  rectal  and  vaginal  specula,  the  endoscope  for  ex- 
amining the  interior  of  the  bladder  and  the  spectroscope 
for  the  detection  of  sugar  and  blood-stains. 

The  laboratory  for  chemical  and  bacteriological  exami- 
nations of  excreta  and  secretions  has  since  been  of  such 
aid  in  diagnosis  that  it  is  hard  to  appreciate  the  fact  that 
the  profession  has  had  its  benefit  only  for  a  few  years  past. 
The  progress  of  physical  diagnosis  has  been  of  incalculable 
benefit  to  humanity;  the  physician  has  been  more  accurate 
in  finding  the  disease  or  its  cause,  and  once  having  estab- 
lished this,  has  been  able  to  treat  the  disease  with  more 
confidence  and  surety. 

The  progress  of  surgery  in  modern  days  has  been  de- 
scribed by  Baas :  "Surgery  has  always  presented  in  its 
development  a  much  pleasanter  picture  of  steady  progress 
than  that  offered  by  medicine  proper,  for  its  objects  and 


Na. 
Fr. 
Pa. 
•Oc. 
Mn. 

St. 

R. 
I?'. 

a. 

Cx. 

Sep. 

Cl. 

H. 

Ma. 

U. 

Cp. 

Me. 
D. 


}.  I 

>r 


!  In  the 
[Thorax. 


The  Nasal  bones. 

The  Frontal  bone. 

The  Parietal  bones.  I  IQ  the  gkulL 

The  Occipital  bone.  | 

The   Mandible, 

Lower  Jaw. 
The     Stermim,    or 

Breastbone. 
The  Ribs. 
The    Cartilages    of 

the  Ribs. 
The  Sacrum. 
The  Coccyx. 

The  Scapula,  or  Shoulder-blade. 
The  Clavicle,  or  Collar-bone. 
The  Humerus. 
The  Radius. 
The  Ulna. 
The      Carpus, 


In  the  Ann. 


or 

Wrist-bones. 
The  Metacarpus. 
The  Phalanges  of 

the    Fingers,    or 

Digits      of      the 

Hand. 

I,  IT,  211,  IF,  V.    The  Pollex,  or  Thumb. 

and  the  succeeding  Fingers. 
Pb.    The  Pubis.      -N  Which         together 
Is.     The  Ischium.  Iform  the  Hip-bone, 

II.  The  Ilium.      J  or  Os  innominatum. 
F.      The  Femur. 

T6.    The  Tibia. 

Fb.    The  Fibula. 

T.      The  Tarsus,  or  An" 

kle-bones. 

Mt.    The  Metatarsus. 
D.     The  Phalanges  of 

the  Toes,  or  Digits 

of  the  Foot. 


In  the  Leg, 


Fig.  10 — HUMAN  SKELETON  IN  PROFILE 


256  MEDICINE 

its  practice  do  not  necessitate  the  illumination  of  dark 
paths  by  the  torch  of  theory,  which  diffuses  far  more  soot 
than  light.  Accordingly  Chamisso  calls  surgery  'the  seeing 
portion  of  the  healing  art/  Thus,  too,  the  surgery  of  our 
century,  in  accordance  with  the  character  of  the  people 
who  have  shared  in  its  development,  but  unaltered  by  the 
opinions  of  schools  and  their  often  varying  methods,  has 
striven  vigorously  and  steadily  after  a  perfection  based 
upon  the  foundation  of  experience  and  for  principles  which 
the  past,  and  particularly  the  eighteenth  century,  had 
taught.  If  the  sixteenth  century  opened  the  way  for  the 
checking  of  hemorrhage  and  established  this  art  in  its, 
scientific  position,  and  if  the  seventeenth  century  accom- 
plished the  same  results  in  the  simplification  and  improve- 
ment of  the  art  of  dressing  wounds;  if  too  the  eighteenth 
century  gave  a  scientific  elevation,  so  far  as  its  means 
would  permit,  to  both  these  methods,  so  in  our  own  century 
surgery  stands  upon  a  scientific  level  with  medicine  proper, 
tho  its  objects  are  far  more  accessible,  direct  and  com- 
prehensible than  those  of  the  latter  science  and  its  position 
more  favorable,  so  that  its  progress  has  been  almost  con- 
stant and  uninterrupted. 

"In  full  possession  of  the  results  of  a  normal  surgical 
and  topographical  anatomy,  almost  perfect  in  its  develop- 
ment (a  position  which  admits  of  both  boldness  and  cer- 
tainty in  treatment),  it  has  likewise  been  able  to  utilize  in 
an  eminently  practical  way  the  acquisitions  of  pathological 
anatomy,  applying  them  as  well  to  diagnosis  as  to  operative 
and  therapeutic  aims.  Microscopic  pathological  anatomy  in 
particular  has  become  of  extended  importance  in  surgical 
knowledge  and  practice.  By  it,  above  all,  our  knowledge 
of  secondary  wound-diseases,  of  the  fate  of  the  secretions 
of  wounds  and  their  effects  upon  the  organism,  of  the 
character  of  the  different  forms  of  tumors  and  their  meth- 
ods of  growth  and  diffusion,  etc.,  has  been  rendered 
clearer,  and  thus  many  fruitful  facts  and  views  have  been 
contributed  to  surgical  treatment. 


MODERN  TREATMENT  OF  DISEASE       257 

"Above  all  the  external  conditions  of  the  healing  process 
have  been  observed  more  attentively  than  in  the  entire 
past,  and  consequently  the  after-treatment  of  wounds,  both 
local  and  hygienic,  has  been  brought  more  into  the  fore- 
ground. Above  all,  amputations,  so  frequent  at  an  earlier 
date,  have  largely  disappeared,  and  military  surgery,  as 
well  as  hospital  and  civil  surgery,  has  inclined  rather  to 
the  preservation  of  wounded  parts  and  members  than  to 
their  removal.  Thus  has  grown  up  the  scientific  and 
rational,  so-called  conservative  surgery  of  our  century. 

"A  characteristic  stamp  has  been  impressed  upon  the 
surgery  of  our  century  by  the  bold  and  somewhat  unex- 
pectedly successful  practice  of  visceral  surgery,  or  the 
surgery  of  the  cavities  of  the  body,  from  the  ligation  of  the 
great  internal  vessels  to  the  extirpation  of  ovarian  tumors, 
the  spleen,  kidneys,  larynx,  etc.,  a  practice  which  contrasts 
strongly  with  that  of  earlier  surgery,  which  was,  on  the 
whole,  rather  a  surgery  of  the  outer  members,  if  such  an 
expression  is  permissible." 

Also  should  be  mentioned  the  improvement  in  plastic  op- 
erations, among  which  should  be  counted  the  operation  of 
osteoplasty,  introduced  by  B.  Langenbeck  in  1859.  The 
operations  mentioned  and  other  operative  methods,  some 
of  them  tedious  and  difficult,  were  certainly  greatly  facili- 
tated, in  fact  almost  conditioned,  by  the  discovery  of  the 
anesthetic  effects  of  ether  and  chloroform,  one  of  the  most 
beneficent  discoveries  ever  made.  The  rapid  operations  of 
an  earlier  date  now  disappeared,  and  instead  of  rapidity  of 
method,  the  security  of  the  patient  and  the  certainty  of 
success  were  now  demanded.  Pain  was  no  longer  the 
occasion  for  an  avoidance  of  more  tedious,  but  safer  meth- 
ods of  procedure.  Another  advance  in  surgery,  not  so 
beneficent,  however,  in  its  results,  was  the  rubber  bandage 
of  Esmarch,  introduced  in  1873  for  the  production  of  arti- 
ficial anemia. 

The  use  of  animal  fibers  for  sutures  was  suggested  first 
by  Sir  Astley  Cooper.  In  1852  plaster  bandages  were  used 


258  MEDICINE 

first  and  have  been  constantly  employed  since  then  for 
fractures. 

The  discovery  of  anesthesia  by  Dr.  William  T.  G.  Mor- 
ton in  1846  was  one  of  the  greatest  boons  to  mankind  that 
the  history  of  the  world  records.  For  many  centuries  and 
in  many  climes  there  had  been  constant  search  for  the 
abolishment  of  pain  during  operations.  The  Chinese  have 
been  able,  or  made  claims  to  that  effect,  to  produce  anesthe- 
sia by  means  of  a  preparation  they  call  Mago.  Herodotus 
says  that  the  Scythians  were  accustomed  to  intoxicate 
themselves  by  the  inhalation  of  the  fumes  of  hemp-seed. 
Pliny  tells  of  the  anesthetic  qualities  of  the  mandragora 
and  its  use  preparatory  to  surgical  operations.  Opium  and 
hyoscyamus  were  used  in  the  Middle  Ages,  and  this  was 
continued  down  to  the  time  of  Morton's  discovery  of  pure 
sulphuric  ether  as  a  perfect  narcotic  and  anesthetic.  He 
was  a  dentist  and  experimented  on  himself  in  Boston.  His 
description  follows :  "I  shut  myself  up  in  my  room,  seated 
myself  in  the  operating  chair  and  commenced  inhaling.  It 
partially  suffocated  me,  but  produced  no  decided  effect.  I 
then  saturated  my  handkerchief  and  inhaled  it  from  that. 
I  looked  at  my  watch  and  soon  lost  consciousness.  As  I 
recovered,  I  felt  a  numbness  in  my  limbs  with  a  sensation 
like  a  nightmare  and  would  have  given  the  world  for  some 
one  to  come  and  arouse  me.  I  thought  for  a  moment  I 
should  die.  At  length  I  felt  a  slight  tingling  of  the  blood 
in  the  end  of  my  third  finger  and  made  an  effort  to  touch 
it  with  my  thumb,  but  without  success.  At  a  second  effort 
I  touched  it,  but  there  seemed  to  be  no  sensation.  I  pinched 
my  thigh,  but  sensation  was  imperfect.  I  immediately 
looked  at  my  watch.  I  had  been  insensible  between  seven 
and  eight  minutes." 

Shortly  after  Morton's  discovery  of  ether,  which  was 
not  fully  appreciated  at  the  time  except  in  Boston,  Pro- 
fessor Simpson,  of  Edinburgh,  introduced  chloroform  to  be 
used  for  destroying  pains  in  obstetrics. 

To  Lord  Lister,  of  England,  is  due  the  introduction  of 
the  antiseptic  method  in  the  surgical  treatment  of  wounds, 


MODERN  TREATMENT  OF  DISEASE       259 

from  which  was  later  developed  the  aseptic  technique  now 
employed  in  every  hospital  and  in  all  surgical  operations. 
In  the  Lancet  for  March  16,  1867,  Lister  published  the  first 
of  a  series  of  articles  entitled  "On  a  New  Method  of  Treat- 
ing Compound  Fracture,  Abscess,  etc.,  with  Observation 
on  the  Condition  of  Suppuration."  In  the  first  article  of 
this  series  the  following  statements  appear: 

"Turning  now  to  the  question  how  the  atmosphere  pro- 
duces decomposition  of  organic  substances,  we  find  that  a 
flood  of  light  has  been  thrown  upon  this  most  important 
subject  by  the  philosophic  researches  of  M.  Pasteur,  who 
has  demonstrated  by  thoroly  convincing  evidence  that 
it  is  not  to  its  oxygen  or  to  any  of  its  gaseous  constituents 
that  the  air  owes  this  property,  but  to  minute  particles  sus- 
pended in  it,  which  are  the  germs  of  various  low  forms  of 
life,  long  since  revealed  by  the  microscope  and  regarded 
as  merely  accidental  concomitants  of  putrescence,  but  now 
shown  by  Pasteur  to  be  its  essential  cause,  resolving  the 
complex  organic  compounds  into  substances  of  simpler 
chemical  constitution,  just -as  the  yeast  plant  converts 
sugar  into  alcohol  and  carbonic  acid. 

"Applying  these  principles  to  the  treatment  of  compound 
fracture,  bearing  in  mind  that  it  is  from  the  vitality  of  the 
atmospheric  particles  that  all  the  mischief  arises,  it  appears 
that  all  that  is  requisite  is  to  dress  the  wound  with  some 
material  capable  of  killing  these  septic  germs,  provided 
that  any  substance  can  be  found  reliable  for  this  purpose, 
yet  not  too  potent  as  a  caustic. 

"My  attention  having  for  several  years  been  directed  to 
the  subject  of  suppuration,  more  especially  in  its  relation 
to  decomposition,  I  saw  that  such  a  powerful  antiseptic 
was  peculiarly  adapted  for  experiments  with  a  view  to 
elucidating  that  subject,  and  while  I  was  engaged  in  the 
investigation  the  applicability  of  carbolic  acid  for  the  treat- 
ment of  compound  fracture  naturally  occurred  to  me. 

"My  first  attempt  of  this  kind  was  made  in  Glasgow 
Royal  Infirmary  in  March,  1865,  in  a  case  of  compound 
fracture  of  the  leg.  It  proved  unsuccessful,  in  conse- 


260  MEDICINE 

quence,  as  I  now  believe,  of  improper  management;  but 
subsequent  trials  have  more  than  realized  my  most  san- 
guine anticipations. 

"Further,  I  have  found  that  when  the  antiseptic  treat- 
ment is  efficiently  conducted,  ligatures  may  be  safely  cut 
-short  and  left  to  be  disposed  of  by  absorption  or  other- 
wise. Should  this  particular  branch  of  the  subject  yield 
all  that  it  promises,  should  it  turn  out  on  further  trial 
that  when  the  knot  is  applied  on  the  antiseptic  principle, 
we  may  calculate  as  securely  as  if  it  were  absent  on  the 
occurrence  of  healing  without  any  deep-seated  suppura- 
tion, the  deligation  of  main  arteries  in  their  continuity 
will  be  deprived  of  the  two  dangers  that  now  attend  it, 
viz.,  those  of  secondary  hemorrhage  and  an  unhealthy 
state  of  the  wound.  Further,  it  seems  not  unlikely  that 
the  present  objection  to  tying  an  artery  in  the  immediate 
vicinity  of  a  large  branch  may  be  done  away  with,  and 
that  even  the  innominate,  which  has  lately  been  the  sub- 
ject of  an,  ingenious  experiment  by  one  of  the  Dublin 
surgeons,  on  account  of  its  well-known  fatality  under  the 
ligature  for  secondary  hemorrhage,  may  cease  to  have  this 
unhappy  character  when  the  tissues  in  the  vicinity  of  the 
thread,  instead  of  becoming  softened  through  the  influence 
of  an  irritating  decomposing  substance,  are  left  at  liberty 
to  consolidate  firmly  near  an  unoffending  tho  foreign 
body. 

"There  is,  however,  one  point  more  that  I  cannot  but 
advert  to,  viz.,  the  influence  of  this  mode  of  treatment 
upon  the  general  healthiness  of  a  hospital.  Previously 
to  its  introduction  the  two  large  wards  in  which  most  of 
my  cases  of  accident  and  of  operation  are  treated  were 
among  the  unhealthiest  in  the  whole  surgical  division  of 
the  Glasgow  Royal  Infirmary,  in  consequence  apparently 
of  those  wards  being  unfavorably  placed  with  reference 
to  the  supply  of  fresh  air,  and  I  have  felt  ashamed  when 
recording  the  results  of  my  practice  to  have  so  often  to 
allude  to  hospital  gangrene  or  pyemia.  It  was  interesting, 


MODERN  TREATMENT  OF  DISEASE        261 

though  melancholy,  to  observe  that  whenever  all  or  nearly 
all  the  beds  contained  cases  with  open  sores,  these  griev- 
ous complications  were  pretty  sure  to  show  themselves; 
so  that  I  came  to  welcome  simple  fractures,  though  in 
themselves  of  little  interest  either  for  myself  or  the  stu- 
dents, because  their  presence  diminished  the  proportion 
of  open  sores  among  the  patients.  But  since  the  antisep- 
tic treatment  has  been  brought  into  full  operation,  and 
wounds  and  abscesses  no  longer  poison  the  atmosphere 
with  putrid  exhalations,  my  wards,  tho  in  other  re- 
spects under  precisely  the  same  circumstances  as  before, 
have  completely  changed  their  character;  so  that  during 
the  last  nine  months  not  a  single  instance  of  pyemia,  hos- 
pital gangrene  or  erysipelas  has  occurred  in  them.  As 
there  appears  to  be  no  doubt  regarding  the  cause  of  this 
change,  the  importance  of  the  fact  can  hardly  be  exag- 
gerated." 

Modern  therapeutics  has  emerged,  or  more  properly, 
has  almost  entirely  emerged,  from  the  great  obscurity  and 
uncertainty  in  which  it  was  formerly  enveloped.  This 
applies  to  the  medical  profession  and  not  to  the  mass  of 
people,  the  laity.  The  former  have  completely  revised 
their  materia  medica,  making  it  much  more  simple  than  it 
has  ever  been  before. 

A  form  of  therapeutics  which  has  lately  been  given 
much  attention  and  which  is  based  upon  MetchnikofFs 
theories  is  that  of  serum-therapy.  Hydrophobia,  diph- 
theria and  tetanus  are  examples  of  the  successful  appli- 
cation of  these  researches.  The  protective  antitoxines, 
taken  from  the  serum  of  the  lower  animals,  when  injected 
early  enough  into  the  diseased  man,  supply  new  strength 
or  protection,  without  which  the  patient  would  surely  die. 
The  dreaded  consumption  and  cerebro-spinal  meningitis 
are  being  studied  and  experimented  upon  now,  the  latter 
already  with  a  considerable  degree  of  success. 


CHAPTER  XI 

MODERN      PHYSIOLOGY 

THE  views  concerning  the  working  of  the  human  body 
and  its  structure,  while  very  complete,  are  not  positive 
even  in  the  present  day.  To  understand  the  functions  of 
the  several  parts  of  the  human  mechanism,  it  is  absolutely 
essential  that  one  should  be  acquainted  with  the  structure 
of  all  its  parts,  even  to  the  smallest  details,  so  that  in  re- 
viewing the  modern  physiological  beliefs  one  also  sees 
modern  anatomy.  Thomas  Huxley  in  his  famous  work  on 
physiology  has  summed  up  the  workings  and  structure  of 
the  human  organism  and  the  following  description  is 
based  upon  his  statements,  these  having  been  brought  up 
to  the  latest  word  in  physiological  and  anatomical  re- 
search. 

"The  body  of  a  living  man,"  he  says,  "performs  a  great 
diversity  of  actions,  some  of  which  are  obvious;  others  re- 
quire more  or  less  careful  observation,  and  yet  others  can 
be  detected  only  by  the  employment  of  the  most  delicate 
appliances  of  science.  Thus  some  part  of  the  body  of  a 
living  man  is  plainly  always  in  motion.  Even  in  sleep, 
when  the  limbs,  head  and  eyelids  may  be  still,  the  inces- 
sant, rise  and  fall  of  the  chest  continue  to  show  that 
slumber  is  proceeding  and  not  death. 

"More  careful  observation,  however,  is  needed  to  detect 
the  motion  of  the  heart,  or  the  pulsation  of  the  arteries, 
or  the  changes  in  the  size  of  the  pupil  of  the  eye  with 
varying  light,  or  to  ascertain  that  the  air  which  is  breathed 

262 


MODERN  PHYSIOLOGY  263 

out  of  the  body  is  hotter  and  damper  than  the  air  which 
is  taken  in  by  breathing.  And,  lastly,  when  an  effort  is 
made  to  ascertain  what  happens  in  the  eye  when  that 
organ  is  adjusted  to  different  distances,  or  what  in  a 
nerve  when  it  is  excited,  or  of  what  materials  flesh  and 
blood  are  made,  or  in  virtue  of  what  mechanism  it  is  that 
a  sudden  pain  makes  one  start,  there  is  need  to  call  into 
operation  all  the  methods  of  inductive  and  deductive  logic, 
all  the  resources  of  physics  and  chemistry  and  all  the 
delicacies  of  the  art  of  experiment.  The  sum  of  the  facts 
and  generalizations  at  which  we  arrive  by  these  various 
modes  of  inquiry,  be  they  simple  or  be  they  refined,  con- 
cerning the  actions  of  the  body  and  the  manner  in  which 
those  actions  are  brought  about,  constitutes  the  science  of 
Human  Physiology. 

"Suppose  a  chamber  with  walls  of  ice,  through  which  a 
current  of  pure  ice-cold  air  passes ;  the  walls  of  the  cham- 
ber will,  of  course,  remain  unmelted.  Now,  having 
weighed  a  healthy  living  man  with  great  care,  let  him 
walk  up  and  down  the  chamber  for  an  hour.  In  doing 
this  he  will  obviously  do  a  considerable  amount  of  work 
and  use  up  a  proportionate  quantity  of  energy,  as  much, 
at  least,  as  would  be  required  to  lift  his  weight  as  high 
and  as  often  as  he  has  raised  himself  at  every  step.  But, 
in  addition,  a  certain  quantity  of  the  ice  will  be  melted 
or  converted  into  water,  showing  that  the  man  has  given 
off  heat  in  abundance.  Furthermore,  if  the  air  which 
enters  the  chamber  be  made  to  pass  through  lime-water,  it 
will  cause  no  cloudy  white  precipitate  of  carbonate  of 
lime,  because  the  quantity  of  carbonic  acid  in  ordinary 
air  is  so  small  as  to  be  inappreciable  in  this  way.  But  if 
the  air  which  passes  out  is  made  to  take  the  same  course, 
the  lime-water  will  soon  become  milky  from  the  precipita- 
tion of  carbonate  of  lime,  showing  the  presence  of  car- 
bonic acid,  which,  like  the  heat,  is  given  off  by  the  man. 

"Again,  even  if  the  air  be  quite  dry  as  it  enters  the  cham- 
ber (and  the  chamber  be  lined  with  some  material  so  as  to 


264  MEDICINE 

shut  out  all  vapor  from  the  melting  ice  walls),  that  which 
is  breathed  out  of  the  man  and  that  which  is  given  off 
from  his  skin  will  exhibit  clouds  of  vapor,  which  vapor, 
therefore,  is  derived  from  the  body.  After  the  expiration 
of  the  hour  during  which  the  experiment  has  lasted,  let 
the  man  be  released  and  weighed  once  more.  He  will  be 
found  to  have  lost  weight.  Thus  a  living,  active  man  con- 
stantly does  mechanical  work,  gives  off  heat,  evolves  car- 
bonic acid  and  water  and  undergoes  a  loss  of  substance," 

Plainly  this  state  of  things  could  not  continue  for  an 
unlimited  period  or  the  man  would  dwindle  to  nothing. 
But  long  before  the  effects  of  this  gradual  diminution  of 
substance  become  apparent  to  a  bystander,  they  are  felt 
by  the  subject  of  the  experiment  in  the  form  of  the  two 
imperious  sensations  called  hunger  and  thirst.  To  still 
these  cravings,  to  restore  the  weight  of  the  body  to  its 
former  amount,  to  enable  it  to  continue  giving  out  heat, 
water  and  carbonic  acid  at  the  same  rate  for  an  indefinite 
period  it  is  absolutely  necessary  that  the  body  should  be 
supplied  with  each  of  three  things  and  with  three  only. 
These  are,  first,  fresh  air;  secondly,  drink — consisting  of 
Avater  in  some  shape  or  other,  however  much  it  may  be 
adulterated;  thirdly,  food.  That  compound  known  to 
chemists  as  proteid  matter  and  which  contains  carbon, 
hydrogen,  oxygen  and  nitrogen,  must  form  a  part  of  this 
food  if  it  is  to  sustain  life  indefinitely,  and  fatty,  starchy 
or  saccharine — i.e.,  carbohydrate  matters — together  with  a 
certain  amount  of  salts,  ought  to  be  contained  in  the  food 
if  it  is  to  sustain  life  conveniently. 

A  certain  proportion  of  the  matter  taken  in  as  food 
either  cannot  be,  or  at  any  rate  is  not  used,  and  leaves 
the  body  as  excrementitious  matter,  having  simply  passed 
through  the  alimentary  canal  without  undergoing  much 
change  and  without  ever  being  incorporated  into  the  actual 
substance  of  the  body.  But,  under  healthy  conditions,  and 
when  only  so  much  as  is  necessary  is  taken,  no  important 
proportion  of  either  proteid  matter,  or  fat,  or  starchy  or 


MODERN  PHYSIOLOGY  265 

saccharine  food  passes  out  of  the  body  as  such.  Almost 
all  real  food  ultimately  leaves  the  body  as  waste  in  the 
form  either  of  water,  or  of  carbonic  acid,  or  of  a  third 
substance  called  urea,  or  of  certain  saline  compounds  or 
salts. 

Chemists  have  determined  that  these  products,  which 
are  thrown  out  of  the  body  and  are  called  excretions, 
contain,  if  taken  together,  far  more  oxygen  than  the  food 
and  water  taken  into  the  body.  Now,  the  only  possible 
source  whence  the  body  can  obtain  oxygen,  except  from 
food  and  water,  is  the  air  which  surrounds  it.  And  care- 
ful investigation  of  the  air  which  leaves  the  chamber  in 
the  imaginary  experiment  described  above  would  show 
not  only  that  it  has  gained  carbonic  acid  from  the  man, 
but  that  it  has  lost  oxygen  in  equal  or  rather  greater 
amount  to  him. 

Thus,  if  a  man  is  neither  gaining  nor  losing  weight, 
the  sum  of  the  weights  of  all  the  substances  above  enu- 
merated which  leave  the  body  ought  to  be  exactly  equal 
to  the  weight  of  the  food  and  water  which  enter  it,  to- 
gether with  that  of  the  oxygen  which  it  absorbs  from  the 
air.  And  this  is  proved  to  be  the  case. 

Hence  it  follows  that  a  man  in  health  and  "neither 
gaining  nor  losing  flesh"  is  incessantly  oxidating  and  wast- 
ing away  and  periodically  making  good  the  loss.  So  that 
if,  in  his  average  condition,  he  could  be  confined  in  the 
scale-pan  of  a  delicate  spring  balance,  like  that  used  for 
weighing  letters,  the  scale-pan  would  descend  at  every 
meal  and  ascend  in  the  intervals,  oscillating  to  equal  dis- 
tances on  each  side  of  the  average  position,  which  would 
never  be  maintained  for  longer  than  a  few  minutes.  There 
is,  therefore,  no  such  thing  as  a  stationary  condition  of 
the  weight  of  the  body,  and  what  we  call  such  is  simply  a 
condition  of  variation  within  narrow  limits — a  condition 
in  which  the  gains  and  losses  of  the  numerous  daily  trans- 
actions of  the  economy  balance  one  another. 

Suppose  this  diurnally  balanced  physiological  state  to 


266  MEDICINE 

be  reached,  it  can  be  maintained  only  so  long  as  the  quan- 
tity of  the  mechanical  work  done  and  of  heat  or  other 
force  evolved  remains  absolutely  unchanged. 

Let  such  a  physiologically  balanced  man  lift  a  heavy 
body  from  the  ground  and  the  loss  of  weight  which  he 
would  have  undergone  without  that  exertion  will  be  in- 
creased by  a  definite  amount,  which  cannot  be  made  good 
unless  a  proportionate  amount  of  extra  food  be  supplied 
to  him.  Let  the  temperature  of  the  surrounding  air  fall, 
and  the  same  result  will  occur  if  his  body  remains  as  warm 
as  before. 

On  the  other  hand,  diminsh  his  exertion  and  lower  his 
production  of  heat,  and  either  he  will  gain  weight  or  some 
of  his  food  will  remain  unused. 

Thus,  in  a  properly  nourished  man,  a  stream  of  food  is 
constantly  entering  the  body  in  the  shape  of  complex  com- 
pounds containing  comparatively  little  oxygen,  as  con- 
stantly the  elements  of  the  food  (whether  before  or  after 
they  have  formed  part  of  the  living  substance)  are  leaving 
the  body  combined  with  more  oxygen.  And  the  incessant 
breaking  down  and  oxidation  of  the  complex  compounds 
which  enter  the  body  are  definitely  proportioned  to  the 
amount  of  energy  the  body  gives  out,  whether  in  the  shape 
of  heat  or  otherwise,  just  in  the  same  way  as  the  amount 
of  work  to  be  got  out  of  a  steam  engine  and  the  amount  of 
heat  it  and  its  furnace  give  off  bear  a  strict  proportion  to 
its  consumption  of  fuel. 

The  condition  to  which  the  name  of  fever  is  given  is 
characterized  essentially  by  the  temperature  of  the  body 
being  higher  than  is  usual  in  health.  Thus  it  may  rise  to 
as  much  as  41°  C.  (105.8°  F.)  or  occasionally  even  above 
this  point,  and  there  has  been  much  dispute  as  to  how  high 
temperature  arises.  A  common  cause  is  a  disturbance  of 
the  mechanism  by  which  heat  is  lost  to  the  body,  some 
diminution  in  loss  of  heat  leading  naturally  to  a  rise  of 
temperature.  On  the  other  hand,  direct  measurement 
shows  that  a  fevered  person  often  gives  off  more  heat 


MODERN  PHYSIOLOGY 


267 


than  usual  and  at  the  same  time  uses  up  more  oxygen 
and  produces  more  carbonic  acid  and  urea  than  usual.  In 
such  cases  there  is  no  doubt  that  the  abnormally  high 
temperature  is  largely  due  to  an  over-production  of  heat. 


Fig.    ii — DIAGRAMMATIC  SECTION   OF   BODY 


Viewed  vertically  through  the  medium  plane.  CS,  the  cerebro- 
spinal  nervous  system  ;  N,  the  cavity  of  the  nose ;  M,  that  of 
the  mouth ;  Al,  Al,  the  alimentary  canal  represented  as  a 
simple  tube ;  H,  the  heart ;  D,  the  diaphragm ;  Sy,  the  sympa- 
thetic ganglia. 


cl 


BONES  OF  LIMBS.    LEFT  FRONT  VIEW 


A,  the  innominate  and  bones  of  the  leg;  inn,  innominate  or  hip- 
bone ;  fern,  femur ;  pat,  patella  or  knee-cap ;  tib,  tibia ;  fib, 
fibula;  tar,  (seven)  tarsal  bones;  metat,  (five)  metatarsal 
bones;  phi,  (fourteen)  phalanges;  B,  the  scapula,  clavicle, 
and  bones  of  the  arm ;  cl,  clavicle  or  collar-bone ;  scap,  scap- 
ula or  shoulder-bone ;  hum,  humerus  ;  rad,  radius ;  uln,  ulna ; 
car,  (eight)  carpal  bones;  metac,  (five)  metacarpal  bones; 
phi,  (fourteen)  phalanges. 


MODERN  PHYSIOLOGY  269 

From  these  general  considerations  regarding  the  nature 
of  life,  considered  as  physiological  work,  one  may  turn  for 
the  purpose  of  taking  a  like  broad  survey  of  the  apparatus 
which  does  the  work. 

The  human  body  is  obviously  separable  into  head,  trunk 
and  limbs.  In  the  head,  the  brain-case  or  skull  is  distin- 
guishable from  the  face.  The  trunk  is  naturally  divided 
into  the  chest  or  thorax  and  the  belly  or  abdomen.  Of  the 
limbs  there  are  two  pairs — the  upper,  or  arms,  and  the 
lower,  or  legs,  and  legs  and  arms  again  are  subdivided  by 
their  joints  into  parts  which  obviously  exhibit  a  rough 
correspondence — thigh  and  upper  arm,  leg  and  forearm, 
ankle  and  wrist,  toes  and  fingers,  plainly  answering  to  one 
another.  And  the  two  last,  in  fact,  are  so  similar  that 
they  receive  the  same  name  of  digits,  while  the  several 
joints  of  the  fingers  and  toes  have  the  common  denomina- 
tion of  phalanges. 

The  whole  body  thus  composed  (without  the  viscera  or 
organs  which  fill  the  cavities  of  the  trunk)  is  seen  to  be 
bilaterally  symmetrical;  that  is  to  say,  if  it  were  split 
lengthwise  by  a  great  knife,  which  should  be  made  to  pass 
along  the  middle  line  of  both  the  dorsal  and  ventral  (or 
back  and  front)  aspects,  the  two  halves  would  almost  ex- 
actly resemble  one  another. 

One-half  of  the  body,  divided  in  the  manner  described, 
would  exhibit  in  the  trunk  the  cut  faces  of  thirty-three 
bones,  joined  together  by  a  very  strong  and  tough  sub- 
stance into  a  long  column,  which  lies  much  nearer  the 
dorsal  (or  back)  than  the  ventral  (or  front)  aspect  of 
the  body.  The  bones  thus  cut  through  are  called  the 
bodies  of  the  vertebrae.  They  separate  a  long,  narrow 
canal  called  the  spinal  canal,  which  is  placed  upon  their 
dorsal  side,  from  the  spacious  chamber  of  the  chest  and 
abdomen,  which  lies  upon  their  ventral  side.  There  is  no 
direct  communication  between  the  dorsal  canal  and  the 
ventral  cavity. 

The  spinal  canal  contains  a  long  white  cord — the  spinal 


Fig.  13 — VERTEBRAL  COLUMN 

A,  side  view,  left  side;  B,  back  view;  C,  1-7,  cervical  vertebrae; 
D,  1-12,  dorsal  (thoracic)  vertebrae;  L,  1-5,  lumbar  verte- 
brae ;  S,  sacrum ;  C,  coccyx ;  sp,  spinous  processes ;  tr,  trans- 
verse processes — (Huxley). 


MODERN   PHYSIOLOGY  271 

cord — which  is  an  important  part  of  the  nervous  system. 
The  ventral  chamber  is  divided  into  the  two  subordinate 
cavities  of  the  thorax  and  abdomen  by  a  remarkable, 
partly  fleshy  and  partly  membranous  partition,  the  dia- 
phragm, which  is  concave  toward  the  abdomen  and  con- 
vex toward  the  thorax.  The  alimentary  canal  traverses 
these  cavities  from  one  end  to  the  other,  piercing  the  dia- 
phragm. So  does  a  long  double  series  of  distinct  masses 
of  nervous  substance,  which  are  called  ganglia.  These 
are  connected  together  by  nervous  cords  and  constitute 
the  so-called  sympathetic  system.  The  abdomen  contains, 
in  addition  to  these  parts,  the  two  kidneys,  one  placed 
against  each  side  of  the  vertebral  column  and  connected 
each  by  a  tube,  the  ureter,  to  a  muscular  bag,  the  bladder, 
lying  at  the  bottom  of  the  abdomen ;  the  liver,  the  pan- 
creas or  "sweetbread,"  and  the  spleen.  The  thorax  en- 
closes, besides  its  segment  of  the  alimentary  canal  and  of 
the  sympathetic  system,  the  heart  and  the  two  lungs.  The 
latter  are  placed  one  on  each  side  of  the  heart,  which  lies 
nearly  in  the  middle  of  the  thorax. 

Where  the  body  is  succeeded  by  the  head  the  upper- 
most of  the  thirty-three  vertebral  bodies  is  followed  by  a 
continuous  mass  of  bone,  which  extends  through  the  whole 
length  of  the  head,  and,  like  the  spinal  column,  separates 
a  dorsal  chamber  from  a  ventral  one.  The  dorsal  chamber, 
or  cavity  of  the  skull,  opens  into  the  spinal  canal.  It  con- 
tains a  mass  of  nervous  matter  called  the  brain,  which  is 
continuous  with  the  spinal  cord,  the  brain  and  the  spinal 
cord  together  constituting  what  is  termed  the  cerebro- 
spinal  system.  The  ventral  chamber,  or  cavity  of  the 
face,  is  almost  entirely  occupied  by  the  mouth  and  phar- 
ynx, into  which  last  the  upper  end  of  the  alimentary  canal 
(called  gullet  or  oesophagus)  opens. 

Thus  the  study  of  a  longitudinal  section  shows  that 
the  human  body  is  a  double  tube,  the  two  tubes  being  com- 
pletely separated  by  the  spinal  column  and  the  bony  axis 
of  the  skull,  which  form  the  floor  of  the  one  tube  and  the 


272  MEDICINE 

roof  of  the  other.  The  dorsal  tube  contains  the  cerebro- 
spinal  axis ;  the  ventral  tube  contains  the  alimentary  canal, 
the  sympathetic  nervous  system,  the  heart  and  the  lungs, 
besides  other  organs. 

Transverse  sections  taken  perpendicularly  to  the  axis  of 
the  vertebral  column  or  to  that  of  the  skull  show  still 
more  clearly  that  this  is  the  fundamental  structure  of  the 
human  body  and  that  the  great  apparent  difference  be- 
tween the  head  and  the  trunk  is  due  to  the  different  size 
of  the  dorsal  cavity  relatively  to  the  ventral.  In  the  head 
the  former  cavity  is  very  large  in  proportion  to  the  size  of 
the  latter;  in  the  thorax  or  abdomen  it  is  very  small. 

The  limbs  contain  no  such  chambers  as  are  found  in 
the  body  and  the  head,  but  with  the  exception  of  certain 
branching  tubes  rilled  with  fluid,  which  are  called  blood- 
vessels and  lymphatics,  are  solid  or  semi-solid  throughout. 

Such  being  the  general  character  and  arrangement  of 
the  parts  of  the  human  body,  it  will  next  be  well  to  con- 
sider into  what  constituents  it  may  be  separated  by  the  aid 
of  no  better  means  of  discrimination  than  the  eye  and  the 
anatomist's  knife. 

With  no  more  elaborate  aids  than  these,  it  becomes  easy 
to  separate  that  tough  membrane  which  invests  the  whole 
body  and  is  called  the  skin,  or  integument,  from  the  parts 
which  lie  beneath  it.  Furthermore,  it  is  readily  enough 
ascertained  that  this  integument  consists  of  two  portions: 
a  superficial  layer,  which  is  constantly  being  shed  in  the 
form  of  powder  or  scales,  composed  of  minute  particles 
of  horny  matter,  and  is  called  the  epidermis,  and  the 
deeper  part,  the  dermis,  which  is  dense  and  fibrous.  The 
epidermis,  if  wounded,  neither  gives  rise  to  pain  nor 
bleeds.  The  dermis,  under  like  circumstances,  is  very 
tender  and  bleeds  freely.  A  practical  distinction  is  drawa 
between  the  two  in  shaving,  in  the  course  of  which  opera- 
tion the  razor  ought  to  cut  only  epidermal  structures,  for 
if  it  go  a  shade  deeper  it  gives  rise  to  pain  and  bleeding. 

The  skin  can  be  readily  enough  removed  from  all  parts 


MODERN  PHYSIOLOGY  273 

of  the  exterior,  but  at  the  margins  of  the  apertures  of  the 
body  it  seems  to  stop,  and  to  be  replaced  by  a  layer  which 
is  much  redder,  more  sensitive,  bleeds  more  readily  and 
which  keeps  itself  continually  moist  by  giving  out  a  more 
or  less  tenacious  fluid  called  mucus.  Hence  at  these  aper- 
tures the  skin  is  said  to  stop  and  to  be  replaced  by  mucous 
membrane,  which  lines  all  those  interior  cavities,  such  as 
the  alimentary  canal,  into  which  the  apertures  open.  But, 
in  truth,  the  skin  does  not  really  come  to  an  end  at  these 
points,  but  is  directly  continued  into  the  mucous  mem- 
brane, which  last  is  simply  an  integument  of  greater  deli- 
cacy, but  consisting  fundamentally  of  the  same  two  layers 
— a  deep,  fibrous  layer,  called  also  dermis,  and  containing 
blood-vessels,  and  a  superficial,  bloodless  one,  now  called 
the  epithelium.  Thus  every  part  of  the  body  might  be 
said  to  be  contained  between  the  walls  of  a  double  bag, 
formed  by  the  epidermis,  which  invests  the  outside  of  the 
body,  and  the  epithelium,  its  continuation,  which  lines  the 
alimentary  canal. 

The  dermis  of  the  skin  and  that  of  the  mucous  mem- 
branes are  chiefly  made  up  of  a  filamentous  substance, 
which  yields  abundant  gelatine  on  being  boiled  and  is  the 
matter  which  tans  when  hide  is  made  into  leather.  This 
is  called  connective  tissue,  because  it  is  the  great  con- 
necting medium  by  which  the  different  parts  of  the  body 
are  held  together.  Thus  it  passes  from  the  dermis  be- 
tween all  the  other  organs,  ensheathing  the  muscles,  coat- 
ing the  bones  and  cartilages  and  eventually  reaching  and 
entering  into  the  mucous  membranes.  And  so  completely 
and  thoroly  does  the  connective  tissue  permeate  almost 
all  parts  of  the  body  that  if  every  other  tissue  could  be 
dissected  away  a  complete  model  of  all  the  organs  would 
be  left  composed  of  this  tissue.  Connective  tissue  varies 
very  much  in  character;  in  some  places  being  very  soft 
and  tender,  at  others — as  in  the  tendons  and  ligaments, 
which  are  almost  wholly  composed  of  it — attaining  great 
Strength  and  density. 


274  MEDICINE 

Among  the  most  important  of  the  tissues  embedded  in 
and  ensheathed  by  the  connective  tissue  are  some  the  pres- 
ence and  action  of  which  can  be  readily  determined  during 
life. 

If  the  upper  arm  of  a  man  whose  arm  is  stretched  out 
be  tightly  grasped  by  another  person,  the  latter,  as  the 
former  bends  up  his  forearm,  will  feel  a  great  soft  mass, 
which  lies  at  the  fore  part  of  the  upper  arm,  swell,  harden 
and  become  prominent.  As  the  arm  is  extended  again  the 
swelling  and  hardness  vanish. 

On  removing  the  skin,  the  body  which  thus  changes  its 
configuration  is  found  to  be  a  mass  of  red  flesh,  sheathed 
in  connective  tissue.  The  sheath  is  continued  at  each  end 
into  a  tendon,  by  which  the  muscle  is  attached,  on  the  one 
hand,  to  the  shoulder-bone  and  on  the  other  to  one  of  the 
bones  of  the  forearm.  This  mass  of  flesh  is  the  muscle 
called  biceps,  and  it  has  the  peculiar  property  of  changing 
its  dimensions — shortening  and  becoming  thick  in  propor- 
tion to  Its  decrease  in  length — when  influenced  by  the  will 
as  well  as  by  some  other  causes,  called  stimuli,  and  of  re- 
turning to  its  original  form  when  let  alone.  This  tem- 
porary change  in  the  dimensions  of  a  muscle,  this  short- 
ening and  thickening,  is  spoken  of  as  its  contraction.  It 
is  by  reason  of  this  property  that  muscular  tissue  becomes 
the  great  motor  agent  of  the  body;  the  muscles  being  so 
disposed  between  the  system  of  levers  which  support  the 
body  that  their  contraction  necessitates  the  motion  of  one 
lever  upon  another. 

These  levers  form  part  of  the  system  of  hard  tissues 
which  constitute  the  skeleton.  The  less  hard  of  these  are 
the  cartilage,  composed  of  a  dense,  firm  substance,  ordi- 
narily known  as  "gristle."  The  latter  are  the  bones,  which 
are  masses  of  tissue,  hardened  by  being  impregnated  with 
phosphate  and  carbonate  of  lime.  They  are  animal  tissues 
which  have  become,  in  a  manner,  naturally  petrified;  and 
when  the  salts  of  lime  are  extracted,  as  they  may  be  by 


MODERN  PHYSIOLOGY  275 

the  action  of  acids,  a  model  of  the  bone  in  soft  and  flexible 
animal  matter  remains. 

More  than  200  separate  bones  are  ordinarily  reckoned 
in  the  human  body,  though  the  actual  number  of  distinct 
bones  varies  at  different  periods  of  life,  many  bones  which 
are  separate  in  youth  becoming  united  together  in  old  age. 
Thus  there  are  originally,  as  we  have  seen,  thirty-three 
separate  bodies  of  vertebrae  in  the  spinal  column,  and  the 


& 


Coco 


Fig.  14 — PELVIS 

Sac,  sacrum  ;  Cocc,  coccyx  ;  il,  is,  pu,  ilium,  ischium,  pubis,  three 
parts  of  the  innominate  or  hip-bone ;  acet,  acetabulum  or  cup 
for  head  of  femur;  sLV,  5th  lumbar  vertebra;  disc,  disc  of 
cartilage  between  vertebras;  R,  right;  L,  left — (Huxley). 

upper  twenty-four  of  these  commonly  remain  distinct 
throughout  life.  But  the  twenty-fifth,  twenty-sixth,  twenty- 
seventh,  twenty-eighth  and  twenty-ninth  early  unite  into 
one  great  bone,  called  the  sacrum,  and  the  four  remaining 
vertebrae  often  run  into  one  bony  mass  called  the  coccyx. 
In  early  adult  life  the  skull  contains  twenty-two  natu- 


276  MEDICINE 

rally  separate  bones,  but  in  youth  the  number  is  much 
greater  and  in  old  age  far  less. 

Twenty-four  ribs  bound  the  chest  laterally,  twelve  on 
each  side,  and  most  of  them  are  connected  by  cartilages 
with  the  breast-bone  or  sternum.  In  the  girdle  which 
supports  the  shoulder  two  bones  are  always  distinguishable 
as  the  scapula,  or  shoulder-blade,  and  the  clavicle,  or 
collar-bone.  The  pelvis,  to  which  the  legs  are  attached, 
consists  of  two  separate  bones  called  the  ossa  innominata, 
or  hip-bones,  in  the  adult;  but  each  os  innominatum  is 
separable  into  three  (called  pubis,  ischium  and  ilium)  in 
the  young. 

There  are  thirty  bones  in  each  of  the  arms  and  the  same 
number  in  each  of  the  legs,  counting  the  patella,  or  knee- 
pan. 

All  these  bones  are  fastened  together  by  ligaments,  or  by 
cartilages,  and  where  they  play  freely  over  one  another  a 
coat  of  cartilage  furnishes  the  surfaces  which  come  into 
contact.  The  cartilages  which  thus  form  part  of  a  joint 
are  called  articular  cartilages  and  their  free  surfaces,  by 
which  they  rub  against  each  other,  are  lined  by  a  delicate 
synovial  membrane,  which  secretes  a  lubricating  fluid — the 
synovia. 

Tho  the  bones  of  the  skeleton  are  all  strongly  enough 
connected  together  by  ligaments  and  cartilages,  the  joints 
play  so  freely  and  the  center  of  gravity  of  the  body,  when 
erect,  is  so  high  up,  that  it  is  impossible  to  make  a  skeleton 
or  a  dead  body  support  itself  in  the  upright  position.  That 
position,  easy  as  it  seems,  is  the  result  of  the  contraction 
of  a  multitude  of  muscles  which  oppose  and  balance  one 
another.  Thu"s  the  foot  affording  the  surface  of  support, 
the  muscles  of  the  calf  must  contract  or  the  legs  and  body 
would  fall  forward.  But  this  action  tends  to  bend  the  legs, 
and  to  neutralize  this  and  keep  the  leg  straight,  the  great 
muscles  in  front  of  the  thigh  must  come  into  play.  But 
these,  by  the  same  action,  tend  to  bend  the  body  forward 
on  the  legs,  and  if  the  body  is  to  be  kept  straight,  they 


MODERN  PHYSIOLOGY  277 

must  be  neutralized  by  tHe  action  of  the  muscles  of  the 
buttocks  and  of  the  back. 

The  erect  position,  then,  which  we  assume  so  easily  and 
without  thinking  about  it,  is  the  result  of  the  combined  and 
accurately  proportioned  action  of  a  vast  number  of  mus- 
cles. What  is  it  that  makes  them  work  together  in  this 
way? 


Fig.  I5 — SIDE  VIEW  OF  SKULL 

f,  Frontal  bone ;  p,  parietal ;  o,  occipital ;  a,  wing  of  sphenoid ; 
s,  flat  part  of  temporal ;  c,  m,  st,  other  parts  of  temporal ; 
au,  opening  of  ear  or  external  auditory  canal ;  z,  process  of 
temporal  passing  to  j,  the  cheek-bone;  mx,  the  upper  jaw 
bone ;  n,  nasal  bone ;  1,  lachrymal ;  pt,  part  of  sphenoid.  The 
lower  jaw  bone  is  drawn  downward  :  cy,  its  process  which 
articulates  with  the  temporal ;  cr,  its  process  to  which  muscles 
of  mastication  are  attached ;  th,  ty,  hyoid  bone,  the  dotted 
line  indicating  its  attachment  by  a  ligament  to  the  temporal — 
(Huxley). 

Let  any  person  in  the  erect  position  receive  a  violent 
blow   on   the    head,    and   the    effect    is    rapid.       On    the 


278  MEDICINE 

instant  he  drops  prostrate,  in  a  heap,  with  his  limbs  re- 
laxed and  powerless.  What  has  happened  to  him?  The 
blow  may  have  been  so  inflicted  as  not  to  touch  a  single 
muscle  of  the  body ;  it  may  not  cause  the  loss  of  a  drop  of 
blood;  and,  indeed,  if  the  "concussion/'  as  it  is  called,  has 
not  been  too  severe,  the  sufferer,  after  a  few  moments  of 
unconsciousness,  will  come  to  himself  and  be  as  well  as 
ever  again.  Clearly,  therefore,  no  permanent  injury  has 
been  done  to  any  part  of  the  body,  least  of  all  to  the  mus- 
cles, but  an  influence  has  been  exerted  upon  a  something 
which  governs  the  muscles.  And  a  similar  influence  may 
be  the  effect  of  very  subtle  causes.  A  strong  mental  emo- 
tion, and  even  a  very  bad  smell,  will,  in  some  people,  pro- 
duce the  same  effect  as  a  blow. 

These  observations  might  lead  to  the  conclusion  that  it 
is  the  mind  which  directly  governs  the  muscles,  but  a 
little  further  inquiry  will  show  that  such  is  not  the  case. 
For  people  have  been  so  stabbed  or  shot  in  the  back  as  to 
cut  the  spinal  cord  without  any  considerable  injury  to 
other  parts,  and  then  they  have  lost  the  power  of  standing 
upright  as  much  as  before,  tho  their  minds  may  have 
remained  perfectly  clear.  And  not  only  have  they  lost  the 
power  of  standing  upright  under  these  circumstances,  but 
they  no  longer  retain  any  power  of  either  feeling  what  is 
going  on  in  their  legs,  or,  by  an  act  of  their  own  will, 
causing  motion  in  them. 

And  yet,  tho  the  mind  is  thus  cut  off  from  the  lower 
limbs,  a  controlling  and  governing  power  over  them  still 
remains  in  the  body.  For  if  the  soles  of  the  disabled  feet 
be  tickled,  though  the  mind  does  not  feel  the  tickling,  the 
legs  will  be  jerked  up,  just  as  would  be  the  case  in  an 
uninjured  person.  Again,  if  a  series  of  galvanic  shocks 
be  sent  into  the  spinal  cord,  the  legs  will  perform  move- 
ments even  more  powerful  than  those  which  the  will  could 
produce  in  an  uninjured  person.  And,  finally,  if  the  in- 
jury is  of  such  a  nature  as  not  simply  to  divide  or  injure 
the  spinal  cord  in  one  place  only,  but  to  crush  or  pro- 


MODERN  PHYSIOLOGY  279 

foundly  disorganize  it,  all  these  phenomena  cease ;  tickling 
the  soles,  or  sending  galvanic  shocks  along  the  spine,  will 
produce  no  effect  upon  the  le^s. 

By  examinations  of  this  knd  carried  still  further,  the 
remarkable  result  is  reached  that,  while  the  brain  is  the 
seat  of  all  sensation  and  mental  action  and  the  primary 
source  of  all  voluntary  muscular  contractions,  the  spinal 
cord  is  by  itself  capable  of  receiving  an  impression  from 
the  exterior  and  converting  it,  not  only  into  a  simple  mus- 
cular contraction,  but  into  a  combination  of  such  actions. 

Thus,  in  general  terms,  it  may  be  said  of  the  cerebro- 
spinal  nervous  centers,  that  they  have  the  power,  when 
they  receive  certain  impressions  from  without,  of  giving 
rise  to  simple  or  combined  muscular  contractions. 

But  these  impressions  from  without  are  of  very  different 
characters.  Any  part  of  the  surface  of  the  body  may  be 
so  affected  as  to  give  rise  to  the  sensations  of  contact  or 
of  heat  or  cold,  and  any  or  every  substance  is  able,  under 
certain  circumstances,  to  produce  these  sensations.  But 
only  very  few  and  comparatively  small  portions  of  the 
bodily  framework  are  competent  to  be  affected  in  such  a 
manner  as  to  cause  the  sensations  of  taste  or  of  smell,  of 
sight  or  of  hearing,  and  only  a  few  substances  or  particu- 
lar kinds  of  vibrations  are  able  so  to  affect  those  regions. 
These  very  limited  parts  of  the  body,  which  induce  re- 
lation with  particular  kinds  of  substances  or  forms  of 
force,  are  what  are  termed  sensory  organs.  There  are 
two  such  organs  for  sight,  two  for  hearing,  two  for  smell 
and  one,  or  more  strictly  speaking  two,  for  taste. 

With  this  brief  view  of  the  structure  of  the  body,  of  the 
organs  which  support  it,  of  the  organs  which  move  it  and 
of  the  organs  which  put  it  in  relation  with  the  surrounding 
world,  or,  in  other  words,  enable  it  to  move  in  harmony 
with  influences  from  without,  next  must  be  considered  the 
means  by  which  all  this  wonderful  apparatus  is  kept  in 
working  order. 

All  work  implies  waste.    The  work  of  the  nervous  sys- 


280 


MEDICINE 


tern  and  that  of  the  muscles,  therefore,  implies  consump- 
tion either  of  their  own  substance  or  of  something  else. 
And  as  the  organism  can  nuke  nothing,  it  must  possess  the 
means  of  obtaining  from  without  that  which  it  wants,  and 
of  throwing  off  from  itself  that  which  it  wastes;  and  we 


tt  -*  t 

Fig.  1 6 — SECTION  OF  STOMACH 


a,  Oesophagus ;  b,  cardiac  dilatation ;  c,  lesser  curvature ;  d, 
pylorus ;  e,  biliary  duct ;  f ,  gall-bladder ;  g,  pancreatic  duct 
opening  in  common  with  the  cystic  duct  opposite  h ;  h,  i, 
duodenum — (Huxley) . 

have  seen  that,  in  the  gross,  it  does  these  things.  The 
body  feeds,  and  it  excretes.  Now  passing  from  the  broad 
fact  to  the  mechanism  by  which  the  fact  is  brought  about, 
it  is  seen  that  the  organs  which  convert  food  into  nutri- 
ment are  the  organs  of  alimentation;  those  which  dis- 


MODERN  PHYSIOLOGY  281 

tribute  nutriment  all  over  the  body  are  organs  of  circula- 
tion ;  those  which  get  rid  of  the  waste  products  are  organs 
of  excretion. 

The  circulatory  organs  consist  of  a  system  of  minute 
tubes,  with  very  thin  walls,  termed  capillaries,  which  are 
distributed  through  the  whole  organism  except  the  epi- 
dermis and  its  products,  the  epithelium,  the  cartilages  and 
the  substance  of  the  teeth.  On  all  sides,  these  tubes  pass 
into  others,  which  are  called  arteries  and  veins;  while 
these,  becoming  larger  and  larger,  at  length  open  into  the 
heart,  an  organ  which,  as  has  been  seen,  is  placed  in  the 
thorax.  During  life,  these  tubes  and  the  chambers  of  the 
heart,  with  which  they  are  connected,  are  all  full  of  liquid, 
which  is,  for  the  most  part,  that  red  fluid  with  which  all 
are  familiar  as  blood. 

A  simple  statement  of  the  circulatory  system,  made  re- 
cently by  Albert  M.  Polon,  runs  as  follows:  "There  are 
two  sets  of  tubes  connected  with  the  heart,  viz.,  arteries 
and  veins,  in  which  are  valves  permitting  the  flow  of  the 
blood  in  one  direction  only.  The  terminations  of  the  ar- 
teries are  connected  with  the  veins  by  means  of  minute 
vessels,  called  capillaries.  The  principle  upon  which  the 
blood  is  caused  to  circulate  in  these  tubes  is  well  repre- 
sented by  a  hollow  closed  ring,  with  an  enlargement  at  one 
point  (corresponding  to  the  heart),  in  which  there  is  a 
valve  opening  only  one  way.  It  is  clear  that  if  such  a  ring 
be  filled  with  water  and  placed  upon  the  table  there  will 
be  no  movement  in  the  tube,  but  if  pressure  be  applied,  the 
water  within  the  tube  will  flow  in  the  direction  of  least 
pressure  and  toward  the  point  where  the  valve  opens. 
Just  as  the  difference  of  pressure  thus  is  the  causative  fac- 
tor of  the  flow  in  this  ring,  so  in  the  heart,  arteries,  capil- 
laries and  veins  the  contraction  of  the  heart-muscle  per- 
forms the  same  office.  The  heart  contracting  propels  the 
blood  into  the  arteries.  From  these  the  blood  nasses  into 
the  capillaries,  where  the  pressure  is  lower,  and  thence  it 


282  MEDICINE 

proceeds  into  the  veins,  where  the  pressure  is  still  lower, 
until  it  finally  reaches  the  heart. 

"To  appreciate  clearly  the  working  of  the  circulatory 
system,  it  is  necessary  briefly  to  consider  the  anatomy  of 


Fig.  17 — NECK  AND  THORAX 

Viewed  from  the  back  with  vertebral  column  and  posterior  chest 

wall  removed. 
M,   mouth;    Gl,   glottis;    Tr,   trachea;    LL,    left   lung;    RL,    right 

lung ;   Br,  bronchus ;   PA,  pulmonary  artery ;   PV,  pulmonary 

veins ;  Ao,  aorta ;  D,  diaphragm ;  H,  heart ;  VCI,  vena  cava 

inferior. 

the  heart.  The  heart  is  a  hollow  muscular  organ,  the 
cavity  of  which  is  separated  into  right  and  left  halves  by  a 
longitudinal  section,  and  each  half  is  divided  into  an  upper 


MODERN  PHYSIOLOGY  283 

receiving  chamber,  the  'auricle/  and  the  lower  ejecting 
chamber,  the  Ventricle.'  But  each  ventricle  is  not  com- 
pletely separated  from  the  corresponding  auricle;  the  two 
communicate  by  means  of  an  opening,  called  the  'auricu- 
lar ventricular  aperture/  which  is  provided  with  a  valve, 
allowing  the  passage  of  blood  from  the  auricle  to  the 
ventricle,  but  effectually  preventing  its  return. 

"Let  a  given  quantity  of  blood  be  traced  through  this 
system,  starting  with  one  of  the  larger  arteries.  As  said 
before,  the  blood  will  pass  into  the  smaller  arteries,  thence 
into  the  'arterioles'  and  finally. into  the  capillaries.  From 
here  it  is  drained  into  'venules/  which  grow  larger  and 
larger  to  become  veins  and  terminate  at  the  upper  half  of 
the  right  side  of  the  heart,  viz.,  the  right  auricle.  From 
the  right  auricle  the  blood  is  sent  along  into  the  right  ven- 
tricle. This  in  its  turn  ejects  it  into  the  pulmonary  ar- 
teries, which  carry  blood  to  the  lungs.  From  the  lungs 
the  blood  returns  by  the  pulmonary  veins  to  the  left 
auricle,  from  where  it  enters  into  the  left  ventricle,  to  be 
finally  ejected  into  the  arteries.  Thus  the  circulation  of 
the  blood  has  two  phases:  (i)  When  the  blood  is  ejected 
from  the  right  ventricle  into  the  lungs  and  back  into  the 
left  ventricle,  and  (2)  when  the  blood  ejected  from  the 
left  ventricle  passes  through  the  system  and  is  returned  to 
the  right  side  of  the  heart.  This  first  phase  is  known  as 
'pulmonary'  and  the  second  as  'systemic.'  " 

The  organs  of  alimentation  are  the  mouth,  pharynx, 
gullet,  stomach  and  intestines,  with  their  appendages,  the 
pancreas  and  the  liver.  What  they  do  is,  first,  to  receive 
and  grind  the  food.  They  then  act  upon  it  with  chemical 
agents,  of  which  they  possess  a  store  which  is  renewed  as 
fast  as  it  is  used;  and  in  this  way  convert  the  food  by 
processes  of  digestion  into  a  fluid  containing  nutritious 
matters  in  solution  or  suspension,  and  innutritious  dregs 
or  feces. 

Now  the  fluid  containing  the  dissolved  or  suspended 
nutritive  matters  which  are  the  result  of  the  process  of 


284 


MEDICINE 


digestion,  traverses  the  very  thin  layer  of  soft  and  perme- 
able tissue  which  separates  the  cavity  of  the  alimentary 
canal  from  the  cavities  of  the  innumerable  capillary  vessels 
which  lie  in  the  walls  of  that  canal,  and  so  enters  the 
blood,  with  which  those  capillaries  are  filled.  Whirled 
away  by  the  torrent  of  the  circulation,  the  blood,  thus 
charged  with  nutritive  matter,  enters  the  heart,  and  is 


Fig.  1 8 — URINARY  ORGANS 
R,  right  kidney ;  U,  ureter ; 
Vu,  bladder  ;  Ua,  urethra  ; 
A,  aorta ;  Ar,  right  renal 
artery ;  Ve,  inferior  vena 
cava ;  Vr,  right  renal  vein 
— (Moore). 


Fig.  19 — KIDNEY 
Ct,  cortical  substance ;  M,  me- 
dullary substance;  Py,  pyra- 
mids ;  P,  pelvis  of  kidney ; 
U,  ureter;  RA,  renal  artery — 
(Huxley). 


thence  propelled  into  the  organs  of  the  body.  To  these 
organs  it  supplies  the  nutriment  with  which  it  is  charged; 
from  them  it  takes  their  waste  products,  and,  finally,  re- 
turns by  the  veins  to  the  heart,  loaded  with  useless  and 
injurious  excretions,  which  sooner  or  later  take  the  form 
of  water,  carbonic  acid,  and  urea. 


MODERN  PHYSIOLOGY*  285 

These  excretionary  matters  are  separated  from  the  blood 
by  the  excretory  organs,  of  which  there  are  three — the 
skin,  the  lungs  and  the  kidneys. 

Different  as  these  organs  may  be  in  appearance,  they 
are  constructed  upon  one  and  the  same  principle.  Each, 
in  ultimate  analysis,  consists  of  a  very  thin  sheet  of  tissue, 
like  so  much  delicate  blotting-paper,  the  one  face  of  which 
is  free,  or  lines  a  cavity  in  communication  with  the  ex- 
terior of  the  body,  while  the  other  is  in  contact  with  the 
blood  which  has  to  be  purified. 

The  excreted  matters  are,  as  it  were,  strained  from  the 
blood,  through  this  delicate  layer  of  tissue,  and  on  to  its 
free  surface,  whence  they  make  their  escape. 

Each  of  these  organs  is  especially  concerned  in  the 
elimination  of  one  of  the  chief  waste  products — water, 
carbonic  acid  and  urea — tho  it  may  at  the  same  time 
be  a  means  of  escape  for  the  others.  Thus,  the  lungs  are 
especially  busied  in  getting  rid  of  carbonic  acid,  but  at  the 
same  time  they  give  off  a  good  deal  of  water.  The  duty 
of  the  kidneys  is  to  excrete  urea  (together  with  other  sub- 
stances, chiefly  salts),  but  at  the  same  time  they  pass 
away  a  large  quantity  of  water  and  a  trifling  amount  of 
carbonic  acid;  while  the  skin  gives  off  much  water,  some 
carbonic  acid,  and  a  certain  quantity  of  saline  matter, 
with  a  trace  of  urea. 

Finally,  the  lungs  play  a  double  part,  being  not  merely 
eliminators  of  waste,  or  excretionary  products,  but  im- 
porters into  the  economy  of  a  substance  which  is  not 
exactly  either  food  or  drink,  but  something  as  important 
as  either — to  wit,  oxygen. 

As  the  carbonic  acid  (and  water)  is  passing  from  the 
blood  through  the  lungs  into  the  external  air,  oxygen  is 
passing  from  the  air  through  the  lungs  into  the  blood, 
and  is  immediately  carried  by  the  blood  to  all  parts  of 
the  body.  The  waste  which  leaves  the  body  contains 
more  oxygen  than  the  food  which  enters  the  body.  Indeed 
oxidation,  the  oxygen  being  supplied  by  the  blood,  is  going 


286  MEDICINE 

on  all  over  the  body.  All  parts  of  the  body  are  thus  con- 
tinually being  oxidized,  or,  in  other  words,  are  continually 
burning,  some  more  rapidly  and  fiercely  than  others.  And 
this  burning,  tho  it  is  carried  on  in  a  peculiar  manner, 
so  as  never  to  give  rise  to  a  flame,  yet  nevertheless  pro- 
duces an  amount  of  heat  which  is  as  efficient  as  a  fire  to 
raise  the  blood  to  a  temperature  of  about  37°  C.  (98.6° 
F.)  ;  and  this  hot  fluid,  incessantly  renewed  in  all  parts  of 
the  body  by  the  torrent  of  the  circulation,  warms  the 
body,  as  a  house  is  warmed  by  hot-water  apparatus.  Nor 
is  it  alone  the  heat  of  the  body  which  is  provided  by  this 
oxidation ;  the  energy  which  appears  in  the  muscular  work 
done  by  the  body  has  the  same  source.  Just  as  the  burning 
of  the  coal  in  a  steam-engine  supplies  the  motive  power 
which  drives  the  wheels,  so,  tho  in  a  peculiar  way,  the 
oxidation  of  the  muscles  (and  thus  ultimately  of  the  food) 
supplies  the  motive  power  of  those  muscular  contractions 
which  carry  out  the  movements  of  the  body.  The  food, 
like  coal  combustible  or  capable  of  oxidation,  is  built  up 
into  the  living  body,  which,  in  like  manner  combustible, 
is  continually  being  oxidized  by  the  oxygen  from  the  blood, 
thus  doing  work  and  giving  out  heat. 

These  alimentary,  circulatory  or  distributive,  excretory, 
and  respiratory  (oxidational)  processes  would,  however,  be 
worse  than  useless  if  they  were  not  kept  in  strict  propor- 
tion one  to  another.  If  the  state  of  physiological  balance 
is  to  be  maintained,  not  only  must  the  quantity  of  food 
taken  be  at  least  equivalent  to  the  quantity  of  matter 
excreted ;  but  that  food  must  be  distributed  with  due 
rapidity  to  the  seat  of  each  local  waste.  The  circulatory 
system  is  the  commissariat  of  the  physiological  army. 

Again,  if  the  body  is  to  be  maintained  at  a  tolerably  even 
temperature,  while  that  of  the  air  is  constantly  varying, 
the  condition  of  the  hot-water  apparatus  must  be  most 
carefully  regulated. 

"In  other  words,'"'  says  Huxley,  "a  coordinating  organ 
must  be  added  to  the  organs  mentioned,  and  this  is  found  in 


MODERN  PHYSIOLOGY 


287 


the  nervous  system,  which  not  only  possesses  the  function 
already  described  of  enabling  us  to  move  our  bodies  and 
to  know  what  is  going  on  in  the  external  world ;  but  makes 


Fig.  20 — SECTION  OF  LUNG 


pericardial 
division  of 


A,  muscles,  ribs,  etc.,  of  the 
body  wall ;  B,  pleura,  lining 
the  same;  C,  the  pleural 
space  or  cavity ;  D,  the 
pleural  covering  of  the 
lung ;  E,  connective  tissues 
of  the  lung;  F,  alveoli  of 
the  lung ;  G,  diaphragm  ; 
H,  trachea ;  I,  right  bron- 
chus, branching ;  K,  the 
space  in  which  lies  the  heart.  Note  the 
the  lung  into  two  lobes  (Huxley). 


us  aware  of  the  need  of  food,  enables  us  to  discriminate 
nutritious  from  innutritious  matters,  and  to  exert  the  mus- 
cular actions  needful  for  seizing,  killing  and  cooking; 
guides  the  hand  to  the  mouth,  governs  all  the  movements 


288  MEDICINE 

of  the  jaws  and  of  the  alimentary  canal,  and  determines 
the  due  supply  of  the  juices  necessary  for  digestion. 

"The  various  functions  which  have  been  thus  briefly 
indicated  constitute  the  greater  part  of  what  are  called  the 
vital  actions  of  the  human  body,  and  so  long  as  they  are 
performed,  the  body  is  said  to  possess  life.  The  cessation 
of  the  performance  of  these  functions  is  what  is  ordinarily 
called  death/' 

But  there  are  really  several  kinds  of  death,  which  may, 
in  the  first  place,  be  distinguished  from  one  another  under 
the  two  heads  of  local  and  of  general  death. 

(i)  Local  death  is  going  on  at  every  moment,  and  in 
most,  if  not  in  all,  parts  of  the  living  body.  Individual 
cells  of  the  epidermis  and  of  the  epithelium  are  incessantly 
dying  and  being  cast  off,  to  be  replaced  by  others  which 
are,  as  constantly,  coming  into  separate  existence.  The 
like  is  true  of  blood-corpuscles,  and  probably  of  many 
other  elements  of  the  tissues. 

This  form  of  local  death  is  usually  insensible  and 
is  essential  to  the  due  maintenance  of  life.  But,  occa- 
sionally, local  death  occurs  on  a  larger  scale,  as  the  result 
of  injury,  or  as  the  consequence  of  disease.  A  burn,  for 
example,  may  suddenly  kill  more  or  less  of  the  skin;  or 
part  of  the  tissues  of  the  skin  may  die,  as  in  the  case  of 
the  slough  which  lies  in  the  midst  of  a  boil;  or  a  whole 
limb  may  die,  and  exhibit  the  strange  phenomena  of  morti- 
fication. 

The  local  death  of  some  tissues  is  followed  by  their 
regeneration.  Not  only  all  the  forms  of  epidermis  and 
epithelium,  but  nerves,  connective  tissue,  bone,  and  at  any 
rate,  some  muscles,  may  be  thus  reproduced,  even  on  a 
large  scale. 

(ii)  General  death  is  of  two  kinds,  death  of  the  body 
as  a  whole,  and  death  of  the  tissues.  By  the  former  term 
is  implied  the  absolute  cessation  of  the  functions  of  the 
brain,  of  the  circulatory,  and  of  the  respiratory  organs; 
by  the  latter,  the  entire  disappearance  of  the  vital  actions 


MODERN  PHYSIOLOGY  289 

of  the  ultimate  structural  constituents  of  the  body.  When 
death  takes  place,  the  body,  as  a  whole,  dies  first,  the  death 
of  the  tissues  not  occurring  until  after  an  interval,  which 
is  sometimes  considerable. 

Hence  it  is  that, .  for  some  little  time  after  what  is 
ordinarily  called  death,  the  muscles  of  an  executed  criminal 
may  be  made  to  contract  by  the  application  of  proper 
stimuli.  The  muscles  are  not  dead,  though  the  man  is. 

The  modes  in  which  death  is  brought  about  appear  at 
first  sight  to  be  extremely  varied.  One  speaks  of  natural 
death  by  old  age,  or  by  some  of  the  endless  forms  of 
disease ;  of  violent  death  by  starvation,  or  by  the  innumer- 
able varieties  of  injury,  or  poison.  But,  in  reality,  the 
immediate  cause  of  death  is  always  the  stoppage  of  the 
functions  of  one  of  three  organs:  the  cerebro-spinal  ner- 
vous system,  the  lungs,  or  the  heart.  Thus,  a  man  may 
be  instantly  killed  by  such  an  injury  to  a  part  of  the  brain 
which  is  called  the  spinal  bulb  or  medulla  oblongata  as 
may  be  produced  by  hanging,  or  the  breaking  of  the  neck. 
Or  death  may  be  the  immediate  result  of  suffocation  by 
strangulation,  smothering  or  drowning — or,  in  other  words, 
of  stoppage  of  the  respiratory  functions.  Or,  finally,  death 
ensues  at  once  when  the  heart  ceases  to  propel  blood. 
These  three  organs — the  brain,  the  lungs,  and  the  heart — 
have  been  fancifully  termed  the  tripod  of  life. 

In  ultimate  analysis,  however,  life  has  but  two  legs  to 
stand  upon,  the  lungs  and  the  heart,  for  death  through 
the  brain  is  always  the  effect  of  the  secondary  action  of 
the  injury  to  that  organ  upon  the  lungs  or  the  heart.  The 
functions  of  the  brain  cease  when  either  respiration  or  cir- 
culation is  at  an  end.  But  if  circulation  and  respiration  be 
kept  up  artificially,  the  brain  may  be  removed  without 
causing  death.  On  the  other  hand,  if  the  blood  be  not 
aerated,  its  circulation  by  the  heart  cannot  preserve  life; 
and,  if  the  circulation  be  at  an  end,  mere  aeration  of  the 
blood  in  the  lungs  is  equally  ineffectual  for  the  prevention 
of  death. 


290  MEDICINE 

With  the  cessation  of  life,  the  everyday  forces  of  the 
inorganic  world  no  longer  remain  the  servants  of  the 
bodily  frame,  as  they  were  during  life,  but  become  its 
masters.  Oxygen,  the  slave  of  the  living  organism,  be- 
comes the  lord  of  the  dead  body.  Atom  by  atom,  the' 
complex  molecules  of  the  tissues  are  taken  to  pieces  and 
reduced  to  simpler  and  more  oxidized  substances,  until  the 
soft  parts  are  dissipated  chiefly  in  the  form  of  carbonic 
acid,  ammonia,  water  and  soluble  salts,  and  the  bones  and 
teeth  alone  remain.  But  not  even  these  dense  and  earthy 
structures  are  competent  to  offer  a  permanent  resistance 
to  water  and  air.  Sooner  or  later  the  animal  basis  which 
holds  together  the  earthy  salts  decomposes  and  dissolves — 
the  solid  structures  become  friable,  and  break  down  into 
powder.  Finally,  they  dissolve  and  are  diffused  among  the 
waters  of  the  surface  of  the  globe,  just  as  the  gaseous 
products  of  decomposition  are  dissipated  through  its 
atmosphere. 

It  is  impossible  to  follow,  with  any  degree  of  certainty, 
wanderings  more  varied  and  more  extensive  than  those 
imagined  by  the  ancient  sages  who  held  the  doctrine  of 
transmigration ;  but  the  chances  are,  that,  sooner  or  later, 
some,  if  not  all,  of  the  scattered  atoms  will  be  gathered 
into  new  forms  of  life. 

The  sun's  rays,  acting  through  the  vegetable  world, 
build  up  some  of  the  wandering  molecules  of  carbonic 
acid,  of  water,  of  ammonia  and  of  salts,  into  the  fabric  of 
plants.  The  plants  are  devoured  by  animals,  animals  de- 
vour one  another,  man  devours  both  plants  and  other 
animals.  Thus  there  is  constant  change  of  these  elements 
from  one  living  organism  to  another  through  all  time 
and  ages. 


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